During reassessment, a patient on CPAP therapy is fatigued and no longer following verbal commands. What should you do?

When a patient on CPAP therapy becomes fatigued and is no longer following verbal commands, it indicates a significant decline in their respiratory status and potential inability to maintain effective ventilation. In such situations, the most appropriate action is to provide assisted ventilation with a bag-mask device, which ensures that the patient receives adequate oxygenation and ventilation support.

This intervention is critical because the patient may not be able to maintain their airway effectively or may have insufficient respiratory effort. By using a bag-mask device, you can provide positive pressure ventilation, thereby helping to ensure that oxygen is delivered to the lungs while also removing carbon dioxide, which is especially important when a patient exhibits signs of fatigue and altered consciousness.

Increasing CPAP pressure is not suitable in this scenario, as it may not address the underlying issues of fatigue or decreased responsiveness. Calling for advanced life support is important if the situation worsens, but immediate ventilation support is a priority. Continuing to monitor without intervention would put the patient at risk for respiratory failure, as their condition is deteriorating. Therefore, assisted ventilation is the necessary and correct response in this case.