A chronic alcoholic presented with choking, altered sensorium, and difficulty breathing following an episode of vomiting. The clinical suspicion was aspiration pneumonia, leading to airway obstruction and impaired gas exchange. Immediate intubation was performed to secure the airway, provide oxygenation, and prevent further aspiration of gastric contents. The patient was found to be developing respiratory acidosis due to CO2 retention, a common consequence of hypoventilation and inadequate gas e