Sample interview questions: How do you approach patients with acute or chronic respiratory emergencies or acute respiratory distress syndrome (ARDS) in intensive care units?
Sample answer:
Approach to Patients with Acute or Chronic Respiratory Emergencies or ARDS
Initial Assessment:
- Conduct a rapid clinical assessment, including:
- Vital signs (respiratory rate, oxygen saturation, blood pressure)
- Auscultation of lungs for breath sounds
- Chest X-ray to assess for infiltrates or pneumothorax
Oxygen Therapy:
- Administer supplemental oxygen via nasal cannula or face mask.
- Adjust oxygen flow to maintain SpO2 > 95%.
- Consider high-flow nasal cannula (HFNC) or non-invasive ventilation (NIV) if oxygenation is inadequate with conventional therapy.
Ventilatory Support:
- If NIV fails, intubate and mechanically ventilate the patient.
- Use lung-protective ventilation strategies, such as low tidal volumes (6-8 mL/kg ideal body weight) and high positive end-expiratory pressure (PEEP).
- Monitor arterial blood gases to assess oxygenation and ventilation.
Hemodynamic Support:
- Administer vasopressors or inotropes to maintain adequate blood pressure and organ perfusion.
- Monitor fluid balance to avoid fluid overload or dehydration.
Pharmacologic Management: