A 28-year-old male has arrived in the emergency department following a motor vehicle accident.He has a Glasgow Coma Score of 14.Chest x-ray reveals 5 ribs broken anteriorly in 2 areas each.Physical assessment reveals paradoxical movement of the chest.Breath sounds are diminished and the trachea is midline.Arterial blood gas on nonrebreathing mask is: pH 7.53,partial pressure of carbon dioxide (P_aCO₂)is 25 mm Hg,partial pressure of oxygen (P_aO₂)is 59 mm Hg,arterial oxygen saturation (S_aO₂)93%,bicarbonate (HCO₃^-)23 mEq/L.The respiratory therapist should recommend which of the following for this patient?

Question

Quizplus · Accepted Answer

The arterial blood gas shows that the patient is ventilating,as evidenced by the partial pressure of carbon dioxide (P_aCO₂)of 25 mm Hg.Therefore,this patient does not need to be intubated and ventilated at this time.This also means that the patient does not require noninvasive positive pressure ventilation (NPPV).The patient does have an oxygenation problem,as evidenced by the partial pressure of oxygen (P_aO₂)of 59 mm Hg while on a nonrebreathing mask.This is an indication for continuous positive airway pressure (CPAP).

A 28-Year-Old Male Has Arrived in the Emergency Department Following