Which interventions are appropriate for a patient with decreasing respirations in the burn care context?

• A. Observation and waiting
• B. Bronchodilators only
• C. Respiratory therapy for additional support, intubate, prepare for mechanical ventilation
• D. Elevating legs and turning onto side

Answer: (C)

When respirations are decreasing in a burn patient, the priority is to secure the airway and support ventilation. Inhalation injuries and extensive burns can cause rapid airway edema, mucus plugging, and impaired gas exchange, so a fall in breathing effectiveness signals potential impending respiratory failure. Simply observing or waiting won’t prevent deterioration, and addressing it requires active airway management.

Providing respiratory support and preparing for airway protection means bringing in respiratory therapy as needed and being ready to intubate. Early endotracheal intubation and potential mechanical ventilation help ensure a reliable airway, adequate oxygenation, and appropriate CO2 removal, which are essential in burn patients with signs of respiratory compromise. Bronchodilators might help if there is a bronchospastic component, but they do not address airway edema or provide the definitive airway protection that severe inhalation injury demands.

Elevating legs and turning onto the side do not address the underlying issue of impaired ventilation and can delay necessary airway management. In this context, the combination of respiratory support with imminent airway protection and ventilation is the appropriate course of action.