A patient seen in the emergency department exhibits paralysis of the lower extremities that is getting progressively worse.Vital capacity is 6 mL/kg,maximum inspiratory pressure (MIP)is -17 cm H₂O,and oxygen saturation measured by pulse oximeter (SₚO₂)is 89%.Arterial blood gases are pending.The physician suspects Guillain-Barré syndrome.The most appropriate action at this time is which of the following?

Question

Quizplus · Accepted Answer

This patient's maximum inspiratory rate (MIP)and vital capacity (VC)measurements are both critical.Since the patient has a progressive neuromuscular disease with these critical values and a below normal pulse oximetry reading,this patient should be intubated and mechanically ventilated before the patient develops an acute situation.Placing the patient on a nonrebreather mask or initiating continuous positive airway pressure (CPAP)will not address the fact that the neuromuscular disease is now beginning to affect this patient's ventilator muscle strength.Since protection of the airway may become an issue,invasive ventilation would be the most appropriate action.

A Patient Seen in the Emergency Department Exhibits Paralysis of the Lower