9th January 2024

A 75-year-old lady with background of COPD presents to A&E with 1-week history of shortness of breath and productive yellow cough

A 75-year-old lady with background of COPD presents to A&E with 1-week history of shortness of breath and productive yellow cough. On examination, she is cyanosed. Her respiratory rate is 28, and heart rate is 110. Auscultation of chest reveals crackles throughout the lungs. ABG is done on 2 L of Oxygen, PH 7.1 PCO2 8.4 PO2 6.1 HCO3 29. Chest XR shows hyperinflated lungs. 12 lead ECG shows Atrial Fibrillation with ventricular rate of 120. Bloods show WBC 18. What is the most appropriate management for her presentation?

Select the SINGLE most appropriate option from the list below. Select ONE option only.