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Acute asthma red flags — GPhC CRA MCQ

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HardRespiratory TherapeuticsAcute asthma red flagsGPhC CRA

A clinically stable patient with optimally treated COPD has room-air oxygen saturations of 91% at two routine visits. They are not acutely unwell and stopped smoking six months ago. What is the correct next step in assessing long-term oxygen therapy?

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Correct answer: C — Refer for arterial blood gases on two stable occasions at least three weeks apart

NICE recommends assessing oxygen need when stable room-air saturation is 92% or lower. Formal LTOT assessment uses arterial blood gases on two occasions at least three weeks apart while COPD is stable and treatment optimised. Pulse oximetry identifies who needs assessment but does not itself establish eligibility, and an exacerbation ABG is not a stable baseline. Ambulatory oxygen also requires specialist assessment and demonstrated benefit. Smoking status and fire risk must always be reviewed before oxygen is offered; this patient has already stopped.

Reference: NICE NG115: Long-term oxygen therapy assessment in COPD. https://www.nice.org.uk/guidance/ng115/chapter/Recommendations