CPAP and administeration of oral medications
Posted 21 October 2012 - 10:08 PM
He asked me how I would treat the new onset of symptoms to which I replied I would administer 2.5mg of Morphine SIVP. He challeneged me to consider the administration of ASA and Nitro which would require me to remove the CPAP device.. I stood behind my decision to keep the CPAP device on my patient as the COPD exacerbation was the primary complaint, and there's also a risk to the patient in removing the mask once it is applied, and the angina is secondary and can be relived by the morphine.
Just curious as to what some other opinions of this would be?
Posted 21 October 2012 - 11:48 PM
Posted 22 October 2012 - 12:37 AM
Posted 22 October 2012 - 12:42 AM
Posted 22 October 2012 - 12:46 AM
Posted 22 October 2012 - 01:06 AM
Posted 22 October 2012 - 01:10 AM
Posted 22 October 2012 - 01:20 AM
Posted 22 October 2012 - 02:17 AM
Patient had perioral/peripheral cyanosis with R.R at 32 and 02 sats of 77%. I first started my patient on an NRB at 15lpm while auscaltating lung sounds which revealed wheezes in upper lobes with decreased to bases bilat, and no acoustic shadow or bloody sputum indicating mastocytoma/metastatic lung CA. Still quite possible though, the patient was 65 and a pack a day smoker. The patient didn't improve on 15lpm, and has history of COPD, home 02 x 5 years, I selected CPAP to try and increase the traction of the airways and decrease airway resistance by delivering 5mg ventolin through the CPAP nebulizer attachment.
Another reason I went with with CPAP is because if my patient did end up crashing and needed to be intubated, from what I've seen it is very hard to ween COPD patients off of the vent once they've been tubed.
Posted 22 October 2012 - 02:58 AM
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