If a conscious young female patient is hyperventilating with a marked reduction in tidal volume, what should you do?

• A. Restrain her and provide ventilatory assistance.
• B. Explain to her that you will assist her ventilations.
• C. Insert a nasopharyngeal airway and give oxygen.
• D. Ventilate her at the rate at which she is breathing.

Answer: (B)

When someone is conscious and in respiratory distress but still cooperative, the priority is to ensure adequate ventilation while keeping them calm and involved. The best approach is to explain what you plan to do and obtain their cooperation: tell her you will assist her ventilations. This sets a collaborative tone, reduces anxiety, and allows you to deliver controlled breaths with a bag-valve mask as needed, at an appropriate rate and depth to restore adequate ventilation without overdoing it.

Restraint would escalate fear and risk harm, and inserting an airway device like a nasopharyngeal airway isn't automatically appropriate in a cooperative patient who can follow instructions. Ventilating at the same rate she is breathing would not correct the shallow tidal breaths and could worsen the imbalance in CO2. The aim here is to support and regulate ventilation safely while monitoring her response.