The correct answer is D. Apply CPAP.
This patient is experiencing respiratory distress following a drowning/submersion event, which strongly suggests aspiration and possible pulmonary edema. The key findings include:
Shallow respirations (R 28)
Persistent hypoxia (SpO₂ 92%) despite oxygen therapy
History of water exposure (lake rescue)
Why D is correct (CPAP):
CPAP provides positive pressure, helping to recruit alveoli and improve gas exchange.
It is especially effective in cases of noncardiogenic pulmonary edema, such as near-drowning.
Indicated when:
Patient is awake and breathing
Hypoxia persists despite oxygen therapy
Why the other options are incorrect:
A. 12-lead ECG → Not relevant to respiratory failure from drowning
B. Nitroglycerin → Used for cardiac chest pain/pulmonary edema of cardiac origin, not drowning
C. Rapid transport → Important, but does not address immediate respiratory failure; airway intervention takes priority
Exact Extracts:
“CPAP is indicated for patients with respiratory distress who do not improve with oxygen therapy.”
“Positive pressure ventilation helps improve oxygenation in patients with pulmonary edema.”
“Near-drowning patients may develop respiratory distress due to fluid in the lungs.”
[References:, NREMT EMT Education Standards – Airway, Respiration & Ventilation, National EMS Education Standards – Respiratory Emergencies, NREMT Candidate Handbook – Patient Management, ==========================================, ]
