Question

Your patient is a 24-year-old woman with asthma who is struggling to breathe and is very agitated. She has cyanosis of her lips and nail beds, and is cool and clammy to the touch. When you attempt to assist her ventilations with a bag-valve-mask device, she becomes combative and repeatedly pushes the mask away from her face. Which of the following is the BEST option?

A. Wait for the patient's level of consciousness to decrease so that she can no longer resist your attempts to ventilate.
B. Use a nasal cannula to administer supplemental oxygen.
C. Begin transport immediately and contact medical control for advice.
D. Have your partner restrain the patient's hands so you can ventilate her.

Answer 1

The best option for an asthmatic patient in distress who is resisting a mask is to begin transport immediately and seek medical control advice while considering the administration of supplemental oxygen via a nasal cannula.

Step-by-step explanation:

The patient, a 24-year-old woman with asthma, who is struggling to breathe and showing signs of cyanosis and agitation, should not be restrained or forced to receive ventilation against her will. Instead, the best option is C. Begin transport immediately and contact medical control for advice. This approach ensures the patient can receive medical attention as quickly as possible while also respecting her autonomy. Administering supplemental oxygen with a nasal cannula may be considered to provide immediate relief without causing further distress. Restraints or waiting for a decreased level of consciousness could worsen her anxiety and potentially her clinical situation, and are not the initial steps to take in such a scenario.