A 68-year-old patient with a history of COPD presents to the emergency department with worsening dyspnea, increased sputum production, and a low-grade fever. Which of the following interventions should be prioritized in the initial management of this patient?
Administer oxygen therapy to maintain SpO2 between 88-92%
Prepare for immediate intubation
Administer high-flow oxygen to rapidly increase SpO2 above 98%
The correct answer is to administer oxygen therapy to maintain SpO2 between 88-92%. In COPD exacerbations, oxygen therapy is crucial but must be carefully titrated. Unlike other respiratory conditions, COPD patients often rely on hypoxic drive for respiratory stimulation. Maintaining SpO2 between 88-92% helps prevent hypercapnia while ensuring adequate oxygenation.
While bronchodilators are important in COPD management, they are not the first priority. Corticosteroids, although beneficial, are not the immediate intervention. Intubation is typically reserved for severe cases unresponsive to non-invasive measures. Always start with less invasive interventions in COPD exacerbations, progressing to more aggressive treatments if necessary.
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