Acute Careniche
A 26-year-old woman is brought in three hours after taking about 40 alprazolam tablets with wine. She sleeps but rouses to a loud voice, gags on an oropharyngeal airway and is nursed on her left side. Blood pressure 108/64 mmHg, pulse 88/min, respiratory rate 14/min, oxygen saturation 97% on air, pupils 3 mm and reactive, blood glucose 5.4 mmol/L, electrocardiogram normal. The nurse asks what she should watch for while you review another patient. Which one of the following findings would most strongly indicate that she needs ventilatory support?