Severe Copd (on Inhaled in Medicine / Internal Medicine — 78yo Man | Respiratory / Pulmonology | SMLE Q#16935
SMLE Question #16935
Medicine / Internal Medicine
Respiratory / Pulmonology
Objective: OBJ-123
Last updated: February 2026
A 78-year-old man with severe COPD (on inhaled bronchodilators and inhaled corticosteroid) is brought from a nursing home for 24 hours of worsening breathlessness. He has had fever and purulent sputum for 2 days. He is confused and difficult to arouse. He is in severe respiratory distress with accessory muscle use, paradoxical abdominal movement, and copious upper-airway secretions requiring frequent suctioning. What is the most appropriate next step in management?
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