A 75-Year-Old Man with a Long History of COPD Is

question 27

Multiple Choice

A 75-year-old man with a long history of COPD is brought to the emergency department with shortness of breath.He has a persistent,productive cough with green purulent sputum,cyanosis of the lips and extremities,and is uncooperative.His arterial blood gas values on 2 L/min by nasal cannula are: pH = 7.25; PₐCO₂ = 90 mm Hg; PₐO₂ = 38 mm Hg; SₐO₂ = 59%; HCO₃⁻ = 38 mEq/L.The most appropriate action at this time is which of the following?

• A) IPPB
• B) Mask CPAP
• C) NIV via full face mask
• D) Invasive mechanical ventilation

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