A recently extubated patient develops a partial upper airway obstruction, which causes stridor. What action can the respiratory therapist take to improve the patient's condition?
a. Aerosolize 11.25 mg (2.25% solution) of racemic epinephrine.
b. Put a nonrebreather mask on the patient.
c. Place the patient on NPPV.
d. Suggest the use of lorazepam (Ativan).
ANS: A
This patient has developed postextubation glottic edema and should be treated immediately with aerosolized racemic epinephrine. The patient also could be given steroids. A nonrebreather mask would not address the upper airway obstruction unless the mask is powered by heliox. This would allow time for the medical treatment to take effect. Use of an antianxiety drug is not in-dicated in this situation, because it would decrease the patient's drive to breathe. Putting the pa-tient on NPPV would not address the patient's immediate problem.
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