Answer
Occasionally, large increases in CO2 can lead to deterioration of mental status, causing stupor and obtundation. In such cases, decreasing O2 delivery is the wrong action. The CO2 narcosis inhibits respiratory drive to the point that decreasing O2 delivery leads only to worsening of hypoxia. The correct action is immediate intubation and oxygenation.
Supply the patient with enough oxygen to maintain a near normal saturation (above 90%) and do not be concerned about oxygen supplementation leading to clinical deterioration. If the patient's condition is that tenuous, intubation most likely is needed anyway.
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