Severe COPD exacerbation — DipIMC MCQ

Correct answer: B — Titrate oxygen to an appropriate target and support ventilation while treating bronchospasm

Titrate oxygen to an appropriate target and support ventilation while treating bronchospasm is the best answer because COPD exacerbation with ventilatory failure needs controlled oxygen and ventilatory support rather than oxygen alone. Defer treatment until a senior hospital doctor reviews the patient is less appropriate because pre-hospital clinicians must treat immediate threats within scope; Use oral analgesia as the main treatment is less appropriate because oral therapy is inadequate or unreliable in major trauma. Immobilise every joint and delay departure for a detailed examination and Give unrestricted crystalloid to normalise blood pressure are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: JRCALC Guidelines; British Thoracic Society oxygen guidance