Cough Reflex Test (CRT) Practice

In cases of refractory hypoxemia, particularly when a patient is already on a non-rebreather mask, introducing Continuous Positive Airway Pressure (CPAP) therapy can be beneficial. CPAP provides a constant pressure that helps keep the alveoli open during both inspiration and expiration, thus improving ventilation and oxygenation. This method enhances the oxygen exchange in the lungs and can significantly reduce work of breathing.

By using CPAP, the therapist can help recruit collapsed lung units and decrease the shunting of blood through poorly ventilated areas, leading to improved oxygenation. Since the patient is already using a non-rebreather mask, which delivers a high concentration of oxygen, CPAP offers a step up in ensuring that the patient's lungs are capable of utilizing that oxygen more effectively.

Other approaches, such as switching to a high-flow nasal cannula or modifying the flow rate of oxygen, may not provide the necessary pressure support to address the underlying issues of lung recruitment and effective gas exchange. Ambu-bag ventilation might be indicated in more severe cases of respiratory failure but is typically not a primary approach in addressing refractory hypoxemia as it does not provide the continuous support that CPAP offers.