A 61-year-old female called EMS after suddenly being awakened in the middle of the night with a feeling that she was "smothering." You arrive to find the patient, very apprehensive and restless, sitting on the living room couch in obvious respiratory distress. Her BP is 160/90 mm Hg, pulse is 110 beats/min and irregular, and respirations are 24 breaths/min and labored. Auscultation of her lungs reveals diffuse rhonchi in all fields. Treatment for this patient should include:
A. oxygen at 4 to 6 L/min via nasal cannula and up to 3 nebulizer treatments.
B. oropharyngeal suctioning and assisted ventilation with a bag-mask device.
C. continuous positive airway pressure and an IV line set to keep the vein open.
D. an IV line with a 250 mL normal saline bolus and oxygen via a nonrebreathing mask.
Answer: C. continuous positive airway pressure and an IV line set to keep the vein open.
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