Management of status asthmaticus

You are called to the emergency room to see a 26-year old asthmatic male in respiratory distress. Arterial blood gas is as follows: pH = 7.11, pCO2 = 74 mmHg, pO2 is 72 mmHg on a FIO2 of 40% by facemask.

1. What would you do next?

2. Would you immediately intubate this patient?

3. His status worsens despite adequate medical therapy. Would you intubate?

4. What ventilator settings would you employ after intubation?

Nitrous oxide toxicity

1. In what situations would you avoid nitrous oxide? Explain.

2. What potential dangers to operating room personnel does nitrous oxide pose?