Respiratory acidosis happens when the lungs can’t eliminate enough carbon dioxide (CO₂). CO₂ builds up, forms carbonic acid, and the blood pH drops below 7.35. In the prehospital setting, think hypoventilation: reduced respiratory rate or tidal volume, rising EtCO₂, and a patient who may look drowsy, confused, or increasingly fatigued. Common triggers include opioid toxicity, COPD exacerbation, severe asthma with exhaustion, and neuromuscular weakness. Key takeaway: treat the cause and improve v
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