If a patient exhibits increased work of breathing and remains hypoxic with supplemental oxygen, what should be the next recommendation?

• A. Sedate the patient with Valium
• B. Institute full mechanical ventilatory support
• C. Administer an IPPB treatment
• D. Perform arterial blood gas analysis

Answer: (D)

The next recommended action in this scenario should be performing arterial blood gas analysis. This choice is crucial because arterial blood gas (ABG) analysis provides valuable and detailed information about the patient’s respiratory status, including oxygenation and ventilation levels. Given that the patient is experiencing increased work of breathing and hypoxia, an ABG will help identify the underlying causes, such as respiratory acidosis, metabolic issues, or the adequacy of oxygenation, which in turn guides appropriate treatment strategies.

Identifying the precise issue through ABG analysis can help determine whether the patient requires increased oxygen therapy, mechanical ventilation, or other interventions tailored to their specific needs. This assessment is fundamental in critical care and emergency settings, where understanding the underlying physiological changes is vital for effective management.

Other measures, like administering medications, starting mechanical ventilation, or providing treatments like intermittent positive pressure breathing (IPPB), might be useful depending on the ABG results. However, these actions should be informed by the assessment data that the arterial blood gas analysis would provide.