If a patient’s oxygen saturation drops and the bag-valve is easier to squeeze, what should the therapist do first?

• A. Obtain an arterial blood gas
• B. Examine chest rise and auscultate breath sounds
• C. Call for a chest radiograph
• D. Perform diagnostic chest percussion

Answer: (B)

When a patient's oxygen saturation drops and the bag-valve becomes easier to squeeze, the therapist's immediate concern should be assessing the patient's ventilation efficacy and ensuring adequate air delivery. Examining chest rise and auscultating breath sounds provides critical information about the effectiveness of ventilation and any potential issues such as airway obstruction, improper mask fit, or lung pathology. This approach helps to identify whether the manual ventilation is actually reaching the lungs and if the patient is receiving sufficient oxygenation.

This step is crucial because observing chest rise can confirm that the bag is providing positive pressure ventilation effectively, whereas auscultating breath sounds can help detect any abnormal lung sounds, indicating problems such as pneumothorax, obstructive airway conditions, or other lung-related issues that would impact oxygenation. By prioritizing this assessment, the therapist can quickly identify and address the underlying cause of the drop in oxygen saturation before resorting to more invasive diagnostic procedures or imaging, which could delay needed interventions.