Which patient scenario may benefit from CPAP?

• A. Apneic patient
• B. Unconscious patient with hypotension
• C. Severe facial trauma
• D. Alert patient with respiratory distress following submersion in water

Answer: (D)

CPAP provides a steady positive pressure to the airways, helping keep airways open, recruit collapsed alveoli, and reduce the work of breathing while improving oxygenation. It works best when the patient can protect their airway and cooperate, so noninvasive support is appropriate while the underlying cause is addressed.

In the described scenario, an alert patient experiencing respiratory distress after submersion is a good candidate for CPAP. This patient can follow instructions, has the ability to maintain their airway, and is likely experiencing reversible hypoventilation or mild edema/bronchospasm where noninvasive support can improve oxygenation and reduce effort without intubation.

The other situations are not ideal for CPAP: an apneic patient isn’t breathing, so they need ventilation or airway management rather than CPAP; an unconscious patient with hypotension risks worsened preload reduction and airway protection issues with CPAP; severe facial trauma can prevent a proper mask seal and airway control, making CPAP inappropriate.

So the scenario of an alert patient with respiratory distress after submersion is the one where CPAP is most appropriate.