If the patient is hyperventilating and has adequate oxygenation, rebreathing into a paper bag is sometimes helpful to restore normal acid base balance. In a non-COPD patient, a deeper, more effective breath may be needed. This may require mechanical ventilation. If the patient is not already mechanically ventilated or intubated, and the initial medical interventions do not stabilize the patient, more invasive actions may be taken. Provide adequate oxygenation Mechanical ventilation is used until either the patient can produce adequate ventilatory efforts, or the underlying cause of the respiratory failure is corrected.
Many questions surround the decision to intubate a patient.
One decision is whether the patient will be intubated nasally or orally. There are several important advantages of nasal versus oral intubation. Nasal intubation can be accomplished with little neck motion. This is important when the patient is a trauma victim, and all of the diagnostic tests are not complete or available. The patient does not have to be placed supine for nasal intubation.