Question

A 68-year-old with COPD exacerbation has pH 7.30, PaCO2 60 mm Hg, and moderate dyspnea despite bronchodilators. What is the next best step?

Accepted Answer

Initiate noninvasive ventilation (BiPAP).

Answer

Intubate and ventilate immediately in all such cases.

Answer

Give IV morphine for dyspnea.

Answer

Switch to heliox only.

Answer

Start long-term oxygen therapy now.

Practice question

A 68-year-old with COPD exacerbation has pH 7.30, PaCO2 60 mm Hg, and moderate dyspnea despite bronchodilators. What is the next best step?