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

Multiple Choice

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?

A) Noninvasive Positive Pressure Ventilation (NPPV) 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