Would you treat a patient with COPD who is in severe respiratory distress, using accessory muscle use, cyanotic around the lips, no wheezes, but mild crackles in the bases with 1. Salbutamol, dexamethasone, and then CPAP? 2. Or just Dexamethasone and then CPAP? 3. Or just Salbutamol and CPAP? According to the companion Doc for CPAP it states that “CPAP should be considered as an additive therapy to the bronchoconstriction (specifically COPD exacerbation) or acute cardiogenic pulmonary edema medical directive, not a replacement.” Please clarify for me. Thanks!

Hello, two questions. 1. If I am bagging for a patient in respiratory distress but they do not have a supraglottic airway in, how would I measure their end tidal? Will just attaching my end tidal to the bvm without that same seal provide an accurate reading? 2. If I am assisting ventilations via BVM for a COPD patient who is in respiratory failure should I be concerned about their SpO2 going up to 100? Our current BVM’s don’t have a way to adjust how oxygen they are getting. I don’t want to make my COPD patients hypercapnic by delivering too much O2.