Do you know how to handle COPD patients during sedation without screwing up?

Today’s episode is a special one, thanks to a great question from Debbie Hasty, a longtime friend and a badass PACU/ICU nurse. Debbie wanted some clarity on what to do when a COPD patient on home oxygen starts to desaturate.

First off, let’s discuss GOLD standard. GOLD stands for the Global Initiative for Chronic Obstructive Lung Disease Classification. GOLD 1 is mild, GOLD 2 is moderate, GOLD 3 is severe, and GOLD 4 is very severe. Understanding the severity of COPD (GOLD 1 to GOLD 4) is crucial because it dictates how we manage sedation and oxygen therapy. If you don’t get this, you’re screwing up from the start.

We’ll discuss the importance of getting COPD under control before you start sedating anyone. Remember, patients are notoriously non-compliant. You’ve got to make sure they’re actually sticking to their regimen, or you’re setting yourself up for a world of trouble.

We'll also dive into how to handle potential desaturation, ensuring you monitor closely without tipping the balance. It’s not just about following protocols; it’s about managing the fine line between under-oxygenating and over-oxygenating to prevent complications and provide the best care possible.

Key Takeaways:

• Know Your GOLD Standards: Understand the severity of COPD (GOLD 1 to GOLD 4) and its implications for sedation.


• Sedation Strategies: Use the right sedatives like midazolam or dexmedetomidine to minimize respiratory impact.


• Monitor Closely: Keep a close eye on oxygen levels and patient status, adjusting treatment as needed without over-oxygenating.

Other links and resources mentioned:

• American Association of Moderate Sedation Nurses- https://aamsn.org/


• Episode 35: The Essential Respiratory Assessment- https://podcasts.apple.com/us/podcast/35-the-essential-respiratory-assessment/id1714328671?i=1000666907322

Don’t let uncertainty put your patients at risk—dive into the resources, stay informed, and make every shift count. 

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