Paramedic National Registry Practice

When a patient presents with audible wheezes and stops wheezing after an SVN of Albuterol, what is the next course of action?

1. Monitor the patient closely

2. Prepare to intubate

3. Administer additional Albuterol

4. Apply oxygen therapy

The correct answer is: Prepare to intubate

When a patient presents with audible wheezes and those wheezes diminish after administering a nebulized solution of Albuterol, the appropriate response should focus on ensuring the patient continues to breathe effectively and is stable. This is indicative of potential reactive airway disease, such as asthma or COPD exacerbation, where initial treatment with a bronchodilator has alleviated some of the obstructive symptoms. In this scenario, closely monitoring the patient is crucial. The healthcare provider should observe vital signs, breath sounds, and overall respiratory status. If the wheezes have resolved, it suggests that the bronchial tubes are relaxing and opening up due to the effects of Albuterol. However, the patient should still be closely monitored for any return of symptoms that might necessitate further intervention. If breathing remains stable, additional Albuterol could be given if there is still respiratory distress or if the wheezing returns. Oxygen therapy may also be utilized to ensure adequate oxygen saturation levels. Invasive measures like intubation should only be prepared for if there are signs of significant respiratory failure or distress that suggests the patient cannot maintain their airway or adequate ventilation. The focus should remain on patient safety and comfort while ensuring that all vital parameters return to acceptable ranges before making further decisions.