If a patient on nasal CPAP is retracting and creating fluctuating baseline pressure, what should the therapist do?

In the scenario where a patient on nasal CPAP is experiencing retractions and creating fluctuating baseline pressure, increasing the flow rate is a critical intervention. By increasing the flow rate, the therapist can help to minimize the fluctuations in pressure that may be occurring due to the patient's increased work of breathing. This adjustment can enhance the overall stability of the CPAP system, ensuring that the patient receives a consistent positive airway pressure.

When the flow rate is increased, it helps to meet the patient's ventilatory demands more effectively. This is particularly important if the patient is showing signs of respiratory distress, such as retractions, which indicate increased effort to breathe. Adequate flow can prevent the pressure from dropping below the therapeutic level, aiding in maintaining airway patency and improving oxygenation.

The other options, while they may have their applications, do not directly address the need for maintaining consistent airway support in this situation. For instance, increasing the size of the fixed orifice resistor or adjusting the threshold resistor might not directly improve the situation if the baseline pressure is fluctuating significantly due to the patient's effort. Suctioning the patient, while necessary if there is an airway obstruction due to secretions, does not address the underlying issue of CPAP delivery and consistency in airway