Skip to main content
Cases

Ready to go home, until the gas

A 71-year-old with COPD, day 4 of an exacerbation, is 'much better' and listed for discharge. The morning oxygen saturation is 94 percent on 2 litres, and she is sleepy.

71-year-old womanRespiratory ward, bed 9Fictitious educational patient
COPD, FEV1 38 percent predicted, two admissions last yearHome nebulizersEx-smoker, 50 pack-yearsOsteoporosis

Day 4 · 08:30

The discharge round

The consultant is pleased: wheeze settled, off intravenous steroids, walking to the bathroom. The nurse mentions she 'slept a lot yesterday' and 'was a bit muddled at 06:00'. The oxygen was turned up to 2 litres overnight because the saturation dropped to 86.

Vitals

HR88BP138/78RR14SpO294% (2 L nasal cannula)T36.8

What in this picture stops the discharge?

Answer the question above to continue.