In the case of a patient with suspected barbiturate ingestion, what is the most appropriate immediate intervention?

In the context of suspected barbiturate ingestion, the best immediate intervention focuses on supporting the patient’s respiratory function. Barbiturates are central nervous system depressants that can lead to respiratory depression and impaired gas exchange. Therefore, maintaining adequate oxygenation is critical.

Increasing the fraction of inspired oxygen (FIO2) to 1.0 is appropriate as it ensures that the patient receives the maximum available oxygen, which can help counteract the effects of respiratory depression caused by barbiturates. This is particularly vital in cases where the patient may be hypoventilating or experiencing inadequate oxygenation due to the depressant effects of the ingested substance.

Other interventions such as administering Narcan (naloxone) would not be effective since naloxone primarily reverses the effects of opioid overdoses and is not indicated for barbiturate toxicity. Similarly, using mask CPAP may not address the immediate need for improved oxygenation and respiratory support in a patient suffering from severe respiratory depression. Inducing vomiting is not recommended in cases of barbiturate ingestion due to the risk of aspiration and potential harm to the patient, especially if the airway is already compromised.

Thus, prioritizing oxygen therapy by increasing FIO2 to 1.