Your Patient Is a 44-Year-Old Woman, Alert and Oriented, in Moderate

Multiple Choice

Your patient is a 44-year-old woman, alert and oriented, in moderate distress and complaining of difficulty breathing. She gives a one-week history of fever and malaise, with shortness of breath developing three days ago. She also has left-sided chest pain with deep inspiration and a "phlegmy" cough. Physical examination reveals hot, pale, dry skin, and rhonchi and crackles throughout the left lung. The right lung sounds are clear. HR = 134, BP = 88/64, RR = 24, SaO₂ = 92%. She has a history of two previous myocardial infarctions and takes nitroglycerin as needed. Which of the following is the best course of prehospital management?

A) Endotracheal intubation, ventilation with supplemental oxygen, nebulized albuterol and Atrovent, and corticosteroids IV
B) Albuterol via nebulizer with 100 percent oxygen
C) Oxygen via nonrebreather mask
D) Oxygen via CPAP