12th January 2024

You are the medical registrar on call and are bleeped to see a 65-year-old male patient on the respiratory ward who has been hypotensive for the last couple of hours despite fluid challenge.

You are the medical registrar on call and are bleeped to see a 65-year-old male patient on the respiratory ward who has been hypotensive for the last couple of hours despite fluid challenge. He was admitted with an acute exacerbation of COPD yesterday and started on NIV earlier during the day. 

You notice EPAP to be set at 10cmH20 with an IPAP OF 16cmH20.

Blood pressure is noted to be 80/60

What should be the next step?

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