COPD

Scenario

Jack Little is a 59-year-old panel beater with a past medical history of smoking two packs of cigarettes per day for approximately 40 years (80 pack years), chronic bronchitis, and corpulmonale. Jack was on holidays with his wife in the high, mountainous area when became extremely short of breath. His wife took him to the Emergency Department (ED). On presentation to the ED, Jack was agitated and dyspnoeic at rest and had a Glasgow Coma Scale (GCS) of 15. His physical examination revealed the presence of loud wheeze in the mid-lung fields, a temperature of 38.5 " C, SpO2 88% on room air and a respiratory rate of 28 breaths/min. Jack's lips were bluish color, and he complained of new-onset ankle swelling. During the past three days, Jack has had a productive cough and was expectorating thick, tenacious, green sputum in the morning on waking up. Dr. Santorini...
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