Question

The respiratory therapist is called to ICU to evaluate a patient on continuous flow CPAP (8 cm H₂O, FIO₂ 0.30) who is showing signs of respiratory distress. The patient's SpO₂ has changed from 94% to 90%. The therapist observes that the CPAP pressure manometer displays negative pressure during inspiration. The therapist should

A) place the patient back on the ventilator at the previous settings.
B) increase inspiratory flow to the CPAP system.
C) assess the patient for excess secretions.
D) increase the CPAP to 10 cm H₂O.

Answer 1

Increasing inspiratory flow to the CPAP system is the recommended action for a patient in respiratory distress showing negative pressure on the CPAP manometer, as it addresses the inspiratory demand and flow mismatch. The correct option is B) increase inspiratory flow to the CPAP system.

Step-by-step explanation:

The signs of respiratory distress and the negative pressure showing on the CPAP pressure manometer could suggest an issue with the inspiratory flow of the CPAP system, which is not meeting the patient's inspiratory demand. Therefore, the recommended action should be B) increase inspiratory flow to the CPAP system. This would help alleviate the negative pressure experienced during inspiration, ideally improving the patient's oxygen saturation and comfort.

In contrast, placing the patient back on the ventilator at the previous settings, assessing the patient for excess secretions without any indication of secretion obstruction, or increasing the CPAP to 10 cm H2O would not directly address the immediate issue of mismatched inspiratory demand and flow. It is important for respiratory therapists to evaluate and adjust CPAP settings in critical care situations to optimize patient outcomes.