A 20-year-old male with decerebrate posturing and a GCS score of 4 should be ventilated at which rate?

In the scenario described, the patient is exhibiting decerebrate posturing and has a Glasgow Coma Scale (GCS) score of 4, indicating a severe level of brain injury and impaired neurological function. This severely low GCS necessitates immediate and effective ventilation support.

The correct ventilation rate for a patient who is unable to maintain adequate ventilation on their own, particularly in the context of severe trauma and altered consciousness, is generally higher to ensure sufficient oxygenation and ventilation. A rate of 20 breaths per minute is often indicated in such cases to account for the compromised respiratory effort of the patient. This elevated rate helps to manage potential hypoventilation and ensures that adequate tidal volume is achieved, which is crucial in preventing secondary brain injury due to hypoxia.

In contrast, rates such as 10, 12, or 15 breaths per minute may not provide enough respiratory support to adequately ventilate a patient with severe neurological compromise, potentially leading to further deterioration of their condition. Thus, a ventilation rate of 20 breaths per minute is appropriate for this critical scenario, reflecting an urgent and supportive intervention for a patient with profound impairment.