Question

A 68-year-old man with chronic obstructive pulmonary disease (COPD) presents with increased breathlessness, wheeze, and sputum purulence over 3 days. His saturations are 89% on air, respiratory rate 26/min, and there is bilateral wheeze. Which of the following is the most appropriate initial oxygen therapy in the emergency department?

Accepted Answer

Controlled oxygen via Venturi mask aiming saturations 88–92%

Answer

High-flow oxygen via non-rebreathe mask at 15 L/min to achieve saturations of 100%

Answer

No oxygen at all to avoid suppressing his respiratory drive

Answer

Nasal cannulae at 1 L/min aiming saturations above 98%

Answer

Oxygen only if his PaO2 is less than 5 kPa on arterial blood gas

Practice question