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

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 five ribs broken anteriorly in two areas each.Physical assessment reveals paradoxical movement of the chest.Breath sounds are diminished and the trachea is midline.Arterial blood gas on nonrebreather mask is: pH 7.53,partial pressure of carbon dioxide (PₐCO₂) is 25 mm Hg,partial pressure of oxygen (PₐO₂) is 59 mm Hg,arterial oxygen saturation (SₐO₂) 93%,bicarbonate (HCO₃⁻) 23 mEq/L.The respiratory therapist should recommend which of the following for this patient?

A) Noninvasive positive pressure ventilation (NIV) with supplemental oxygen
B) Intubation with volume-controlled continuous mandatory ventilation (VC-CMV) with positive end-expiratory pressure (PEEP)
C) Mask continuous positive airway pressure (CPAP) with supplemental oxygen
D) Intubation with CPAP and pressure support

Correct Answer:

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