Dear Nursing home staff,
I completely understand the ramifications of LONG TERM high concentration oxygen therapy in the COPD patient. I am also aware that the cause of the respiratory distress is likely due to the retention of carbon dioxide.
However, your patient that is belly breathing 28 times a minute with a pulse ox of 78% needs more than just 2 liters per minute via nasal canula. Especially since you told me that this started over an hour ago. How long do you think a 78 year old patient can keep breathing (with accessory muscles) that fast? When I ask how much oxygen the patient is on at the moment, don’t tell me that they are on 2lpm and “they have COPD” with attitude.
Acute respiratory distress requires oxygen therapy, even in patients with COPD. I promise not to keep the patient on high flow oxygen for two days.