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A 68-year-old male with known COPD (GOLD stage III) presents with worsening dyspnea, increased sputum production, and SpO2 of 82% on room air. He is tachypneic with RR 28/min and using accessory muscles. What are the key priorities in initial management: optimal oxygen therapy targets, bronchodilator regimen, role of NIV, and criteria for ICU transfer?
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