Priority Action: Administer low-flow oxygen at 1-2 L/min via nasal cannula. The goal is to maintain SpO2 between 88-92% to correct hypoxemia without suppressing the hypoxic drive.
- Assessment: Monitor level of consciousness, respiratory rate, and ABGs closely. Watch for signs of CO2 narcosis (drowsiness, confusion).
- Rationale: Patients with chronic CO2 retention rely on hypoxia to stimulate breathing. High-flow oxygen can lead to respiratory depression and apnea.
- Ventilatory Support: If the patient's condition deteriorates despite low-flow oxygen, prepare for non-invasive ventilation (BiPAP) to reduce PaCO2.
- Positioning: Keep the patient in an upright or semi-Fowler's position to maximize diaphragmatic excursion.