05-06-2007, 03:25 PM
A 36-year-old firefighter is trapped in a burning building when his air supply runs out. When the rescuers find him 15 minutes later, he is breathing spontaneously and has a pulse, but he is unresponsive. There is no evidence of acute traumatic injury. He is resuscitated with 100% oxygen via a nonrebreathing face mask. He gradually becomes conscious, and by the time he reaches the emergency department, he is awake, alert and complains only of a headache. On arrival in the emergency department arterial blood gas values while breathing 100% oxygen show:
PO2
493 mm Hg
PCO2
29 mm Hg
pH
7.53
Carboxyhemoglobin
30%
Which of the following is the most appropriate management at this time?
A
) Admit the patient for careful monitoring of his airway
B
) Begin phenytoin therapy by intravenous loading
C
) Have the patient rebreathe 100% oxygen at 10 L/min
D
) Intubate the patient in order to allow controlled mechanical ventilation
E
) Measure the concentration of carbon monoxide in his blood
-he is ok now but he still needs 100% o2-c?
PO2
493 mm Hg
PCO2
29 mm Hg
pH
7.53
Carboxyhemoglobin
30%
Which of the following is the most appropriate management at this time?
A
) Admit the patient for careful monitoring of his airway
B
) Begin phenytoin therapy by intravenous loading
C
) Have the patient rebreathe 100% oxygen at 10 L/min
D
) Intubate the patient in order to allow controlled mechanical ventilation
E
) Measure the concentration of carbon monoxide in his blood
-he is ok now but he still needs 100% o2-c?