Problem
During rehearsals, a female dancer comes offstage complaining of shortness of breath. You notice obvious accessory muscle use, she is unable to talk in complete sentences, and she is wheezing. Another dancer informs you that she has asthma. The dancer does not appear to have her inhaler with her, and she is continuing to get worse. Upon your assessment, auscultation reveals the presence of wheezing, which is also audible, and the patient is appearing to become weak from the ongoing attack. SpO2 is 89%, and her respiratory rate is 32 and shallow. You have activated your EAP (emergency action plan). You decide to start her on oxygen and prepare to treat her asthma. Include evidence and reasoning to support your answers.
A. What dose would you provide for oxygen initially?
B. Should you use your emergency kit's albuterol MDI (metered dose inhaler), or should you use your SVN (small volume nebulizer) mask to provide a breathing treatment?
C. What other devices or airway adjuncts might you want to have available should she progress to respiratory arrest?