For a patient with a history of COPD and SpO2 at 86%, what is the most appropriate intervention?

For a patient with a history of COPD and SpO2 at 86%, what is the most appropriate intervention?

• A. Administer high-flow oxygen
• B. Administer oxygen by non-rebreather mask
• C. Ventilate with a bag-valve mask
• D. Provide supplemental oxygen through nasal cannula

Answer: (B)

In a patient with chronic obstructive pulmonary disease (COPD) who presents with a low oxygen saturation (SpO2 of 86%), the most appropriate intervention is to provide supplemental oxygen via a non-rebreather mask. Patients with COPD often have a compromised ability to ventilate and may rely on hypoxic drive to stimulate their breathing. Providing high-flow oxygen can suppress this drive, potentially leading to respiratory depression. By using a non-rebreather mask, you can deliver oxygen at a higher concentration while still enabling the patient to breathe adequately, thus improving oxygen saturation without overwhelming their respiratory drive. This method effectively addresses the low oxygen saturation while mitigating the risk of further complicating their respiratory status. Ventilating with a bag-valve mask is usually reserved for patients who are unable to maintain their airway or who cannot ventilate adequately on their own. In this case, the patient’s SpO2 is low but could still respond to supplemental oxygen without the need for mechanical ventilation. Utilizing a nasal cannula may not provide sufficient oxygen flow to correct the hypoxemia in this specific situation, especially with such a low saturation level. Therefore, the non-rebreather mask is the most suitable option for immediate intervention.

In a patient with chronic obstructive pulmonary disease (COPD) who presents with a low oxygen saturation (SpO2 of 86%), the most appropriate intervention is to provide supplemental oxygen via a non-rebreather mask. Patients with COPD often have a compromised ability to ventilate and may rely on hypoxic drive to stimulate their breathing. Providing high-flow oxygen can suppress this drive, potentially leading to respiratory depression.

By using a non-rebreather mask, you can deliver oxygen at a higher concentration while still enabling the patient to breathe adequately, thus improving oxygen saturation without overwhelming their respiratory drive. This method effectively addresses the low oxygen saturation while mitigating the risk of further complicating their respiratory status.

Ventilating with a bag-valve mask is usually reserved for patients who are unable to maintain their airway or who cannot ventilate adequately on their own. In this case, the patient’s SpO2 is low but could still respond to supplemental oxygen without the need for mechanical ventilation. Utilizing a nasal cannula may not provide sufficient oxygen flow to correct the hypoxemia in this specific situation, especially with such a low saturation level. Therefore, the non-rebreather mask is the most suitable option for immediate intervention.