He's awake alert and orientated, and joking with the nurses and RT. He was placed on a BiPAP not necessarily because he was SOB, but because he had a CO2 of 90 and pH of 7.29, HCO3 34.
He was already given a series of treatments in the ER, but the patient stated to the RT the treatments didn't make him feel any better, "because I'm breathing fine." Yet, Q2-3 treatments were ordered nonetheless by the Internist.
An ABG was ordered in the a.m., and the results were similar to the previous, except the pH decreased to 7.20. Again, he declined any respiratory distress and otherwise showed no signs of distress. In fact, he continued to joke with the health care staff.
On the phone, the doctor decided the patient must be having an exacerbation of COPD, "and we're going to have to knock it out of him. So, I'd like to order a continuous breathing treatment."
No big deal, the RT decides as he sticks the neb inline. Then he decided this doctor made him aware of a new type of 'olin: Respiratory Acidocolin.
As the RT expected, the patient told the RT he feels no different after the 30 minute long treatment.
However, this therapy made the doctor feel better, because 24 hours later his patient's pH was back to normal. "It must have been the ventolin," the Internist chimes to the RT. "It must have been the Ventolin."