05-02-2011, 08:09 AM
A 71-year-old man with a 40 pack year smoking history is admitted with an exacerbation of COPD. He is usually independent at home and manages with no intervention or social support. He has been unwell for the past 3 days with increasing cough productive of purulent sputum. On admission he appears to be significantly hypoxic and hypercapnic, with a pO2 of 7.1, and pCO2 of 5.9. He is very short of breath, but struggles to tell you that he does not want to be ventilated. Unfortunately he becomes increasingly tired and becomes unresponsive some 30 mins later. Which of the following is the most appropriate plan with respect to his further management?
A Continue on antibiotics only
B Contact hospital legal team to proceed to intubate
C Ask the family to consent for him to be intubated
D Intubate and act on the best interests of the patient, whilst informing the relatives
E Withdraw ALL treatment
A Continue on antibiotics only
B Contact hospital legal team to proceed to intubate
C Ask the family to consent for him to be intubated
D Intubate and act on the best interests of the patient, whilst informing the relatives
E Withdraw ALL treatment