Pulmonologist Questions COPD

COPD and hypercapnia?

I am a nurse and recently cared for a patient in the emergency room. She was waiting for admission for exacerbation of C.O.P.D. She was in my department, into the night shift waiting for a bed. She appeared stable with no signs of distress, on oxygen 2l n/c with sats of 93 percent. On transfer from a stretcher to bed noted to be unresponsive requiring intubation and transfer to I.C.U. I assume she developed Co2 narcosis. Can people slip into this condition and become unconscious with no signs of distress?

2 Answers

Absolutely. A blood gas can show you where this person’s PCO2 is at. I’ve found people with baselines in the 50’s and their okay. This is where they normally are. But if they go up into the 80-90’s they become somewhat confused. Of course a nasal cannula to keep their sat is good if kept around 92% they can still have been retaining CO2 and get worse rapidly.