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Anterior shoulder dislocation — ACEM Fellowship MCQ

Instant feedback + full explanation. One question, done properly.

HardMusculoskeletal/Orthopaedic emergenciesAnterior shoulder dislocationACEM Fellowship

A 66-year-old with COPD remains dyspnoeic after bronchodilators. Oxygen is titrated to 90%, arterial blood gas shows PaCO₂ 66 mmHg and pH 7.28, and he is cooperative with an intact airway. Which treatment is most appropriate?

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

Reveal the answer and explanation

Correct answer: E — Trial NIV with monitored escalation

Explanation lettering: C = shown as A · D = shown as C · A = shown as D

E is correct. Acidotic hypercapnic respiratory failure in a cooperative person with COPD is an indication for a closely monitored NIV trial and escalation plan. The other options are not the preferred initial ventilatory strategy.

Reference: NSW Agency for Clinical Innovation: Non-invasive and invasive ventilation: https://aci.health.nsw.gov.au/networks/eci/clinical/tools/ventilation