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Severe COPD exacerbation — DipIMC MCQ

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ModerateMedical EmergenciesSevere COPD exacerbationDipIMC

An older woman with COPD is cyanosed, wheezy and using accessory muscles. SpO2 is 82% on air at home. What is the most appropriate immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Give oxygen immediately, then titrate to target saturations with bronchodilators

Option D is correct because Life-threatening hypoxaemia requires immediate oxygen followed by controlled titration and bronchodilator therapy. Option A is less appropriate because oxygen may be supportive, but it does not address the defining time-critical problem first; option B is less appropriate because vascular access is useful, but it should not delay the immediate priority. Option C is less appropriate because it is plausible in a different scenario but suboptimal for the features described; option E is less appropriate because delay would increase clinical risk. Clinical pearl: in DipIMC-style questions, the best answer is the intervention that changes outcome earliest in the pre-hospital phase.

Reference: JRCALC Guidelines