A 65-year-old woman with COPD and long smoking history presents with worsening somnolence and headache. ABG on 2 L/min oxygen shows pH 7.25, PaCO₂ 70 ...

Question

A 65-year-old woman with COPD and long smoking history presents with worsening somnolence and headache. ABG on 2 L/min oxygen shows pH 7.25, PaCO₂ 70 mmHg, PaO₂ 55 mmHg. What is the most appropriate immediate management?

Accepted Answer

Reduce oxygen to target SpO₂ 88-92% and start non-invasive ventilation

Answer

Increase oxygen to 15 L/min via non-rebreather mask only

Answer

Stop oxygen and observe

Answer

Intubate immediately without trial of non-invasive support

Answer

Give morphine for headache and dyspnoea and observe

au-acem MCQ (SBA): Acute hypercapnic respiratory failure in COPD

A 65-year-old woman with COPD and long smoking history presents with worsening somnolence and headache. ABG on 2 L/min oxygen shows pH 7.25, PaCO₂ 70 mmHg, PaO₂ 55 mmHg. What is the most appropriate immediate management?