Question

A 68-year-old man with known chronic obstructive pulmonary disease (COPD) presents with increased breathlessness, sputum volume and purulence. His oxygen saturation is 88% on air and arterial blood gases show pH 7.34, PaCO₂ 7.0 kPa, PaO₂ 7.2 kPa. What is the most appropriate initial management in the emergency department?

Accepted Answer

Controlled oxygen via Venturi mask aiming SpO₂ 88–92%, nebulised Salbutamol and Ipratropium, oral Prednisolone and consider antibiotics

Answer

High-flow oxygen at 15 L/min via non-rebreathe mask

Answer

Immediate endotracheal intubation and ventilation

Answer

Discharge with oral antibiotics and review in 1 week

Answer

Stop oxygen to avoid CO₂ retention and give oral steroids only

Practice question