A 88-year-old woman with a CFS of 7 and advanced COPD has a ReSPECT form recommending comfort measures and no hospital admission. She develops increas...

Question

A 88-year-old woman with a CFS of 7 and advanced COPD has a ReSPECT form recommending comfort measures and no hospital admission. She develops increasing breathlessness and distress at home. The GP visits and assesses her. She has widespread wheeze and an SpO2 of 85% on air. What is the MOST appropriate action?

Accepted Answer

Provide community-based symptom management: nebulised bronchodilators, oral or subcutaneous corticosteroids, low-dose opioid (Morphine 1-2.5 mg SC) for breathlessness, and consider whether oxygen may provide comfort

Answer

Transfer to hospital as she needs IV medications

Answer

Withhold all treatment as she has a ReSPECT form recommending comfort measures

Answer

Start non-invasive ventilation at home

Answer

Arrange a CT pulmonary angiogram

uk-dgm MCQ (SBA): Community Symptom Management in Advanced COPD