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Post-intubation hypoxaemia — RCPSC EM MCQ

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ModerateResuscitation, procedures, airwayPost-intubation hypoxaemiaRCPSC EM

A 52-year-old man is intubated for septic shock. Five minutes later oxygen saturation falls to 78%, peak airway pressure is high and breath sounds are absent on the left. End-tidal CO2 remains present. Blood pressure has fallen to 72/40 mmHg. What is the most appropriate investigation?

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Correct answer: C — Immediate clinical assessment for right mainstem intubation and tension pneumothorax with tube withdrawal if indicated

Early post-intubation hypoxaemia with unilateral absent breath sounds and high pressures requires immediate bedside assessment using the DOPE framework. A right mainstem tube is common and should be corrected immediately; tension pneumothorax must also be considered.

Reference: ACLS; Canadian airway management practice; Royal College Emergency Medicine Objectives