09-02-2014, 04:43 PM
3. A 67-year-old man with a history of chronic obstructive lung disease is brought to the emergency department by his family. He is in mild respiratory distress with respirations 32/min and some accessory respiratory muscle use. On physical examination he is alert and afebrile. Chest examination is significant for bilateral lower lobe wheezing, loud upper airway sounds, and a cough productive of thick, yellow sputum. In addition to administration of antibiotics, which of the following is the most appropriate treatment at this time?
A) Immediate intubation and mechanical ventilation
B) Initiation of bi-level positive airway pressure (BiPAP) ventilation and admission to medical intensive care unit
C) Serial inhaled albuterol treatments
D) Serial inhaled salmeterol treatments
E) Supplemental oxygen via 40% Venturi face mask
A) Immediate intubation and mechanical ventilation
B) Initiation of bi-level positive airway pressure (BiPAP) ventilation and admission to medical intensive care unit
C) Serial inhaled albuterol treatments
D) Serial inhaled salmeterol treatments
E) Supplemental oxygen via 40% Venturi face mask