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5. Naloxone (Narcan) administration
The patient does not have COPD although that was the reason given for the original referral. COPD produces hypoxemia by ventilation/perfusion mismatch. The cause of his hypoventilation is most likely chronic narcotic administration and not a neuromuscular disease or morbid obesity. Unfortunately, while the respiratory therapist is running the arterial blood gases he is given oxygen initially at 2L/min by nasal cannula. When the SpO2 on the pulse oximeter rises minimally the oxygen flow rate is increased to flood. The patient becomes apneic and cyanotic and a code blue is called. The patient is intubated and placed on mechanical ventilation. The patient is given naloxone and awakens and becomes combative.
What should be done at this time? (Click on the correct answer to proceed to the fifth and final page)