Blue Bloaters

Blue bloaters is the name used to describe COPD (chronic obstructive pulmonary disease) patients who are overweight, puffed up, having difficulty breathing, lacking oxygen (hence the blue, cyanotic discolouration) and have leg swelling due to right heart faillure.  COPD is mainly caused by cigarette smoking.

These patients are hypoxic with low oxygen saturation and some with carbon dioxide retention.  The brain adapts and is reliant on the low oxygen in the blood to drive breathing.  As such, an overdose of oxygen, removing the hypoxic drive, will make them worse leading ultimately to deeper respiratory failure, carbon dioxide narcosis, respiratory arrest and death. 

Therefore, it is very important for caregivers to know exactly how much oxygen (litres per minute) to give to these COPD patients.  Some of these patients may only need to maintain their SpO2 at only 90% to 93% as they are used to these low oxygen to drive ventilation and to "blow out" the carbon dioxide. 

Please consult your doctor for medical advice and not to give too much oxygen to these COPD patients.  Arterial blood gas analysis is required to make a proper diagnosis for these patients. 

Plain Chest Xray

 A CT scan of the lungs will give better definitions than a plain chest x-ray.  However, CT scans are more expensive, needs an appointment and person will receive more radiation. 

Before the Fall of Man

God created man in his own image.  Man is to acknowledge God as the creator of the universe.  Man is to have faith and trust in God that His will is always good for his creation.  With this understanding God will co-create and co-rule with man on earth. 

Man can eat of all the fruits in the Garden of Eden except from the Tree of Knowledge of good and evil.  This test followed by temptation of the serpent created doubt that God should only be the one knowing what is good and evil.  Man wanted to be like God and disobeyed God's command not to eat of the fruit from the Tree of Knowledge. 

Before the Fall, man is allowed even to eat the fruits from the Tree of Life which allows for an eternal relationship with God.