Respiratory

Question 1

Which organism most commonly causes infective exacerbations in COPD?

Answer 1

Haemophilus influenzae

Question 2

Which COPD patients should be referred for assessment for home oxygen?

Answer 2

If peripheral oxygen saturation < 92% on air
Raised JVP or peripheral oedema
Polycythaemia
Cyanosis
Very severe outflow obstruction (FEV1 - <30%) or CONSIDER in severe airflow obstruction (FEV1 30-49%)

Question 3

How is assessment for home oxygen carried out?

Answer 3

Must be done when stable (not during an acute exacerbation) and on optimised COPD treatment

Take 2x arterial blood gases at least 3 weeks apart.

Eligible if pa02 <7.3 kPa
OR
if pa02 <8 kPa with polycythaemia, peripheral oedema or pulmonary hypertension

Contraindications
If SMOKES

They all need a risk assessment before starting home 02.
Need to use it at least 15 hrs per day and ideally 20 hrs per day for maximal benefit