A 35-year-old patient is brought to the emergency department with sudden difficulty breathing and inability to speak. The patient is visibly anxious and produces a harsh, high-pitched sound on inspiration while attempting to breathe. Which intervention should the emergency nurse perform first?
The correct action is to perform abdominal thrusts (Heimlich maneuver). An awake adult who cannot speak and shows signs of poor air exchange-such as a high-pitched inspiratory noise (stridor)-is presumed to have a severe or near-complete foreign-body airway obstruction. Abdominal thrusts create a rapid increase in intrathoracic pressure that can expel the object.
Administering oxygen will not be effective until the obstruction is relieved; air cannot reach the lungs. CPR is reserved for an unresponsive victim, and the patient is still conscious. Preparing for intubation may become necessary if thrusts fail, but delaying thrusts in order to set up equipment wastes critical seconds in a life-threatening choking emergency.
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BCEN CEN
Respiratory Emergencies
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