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Deterioration in an intubated trauma patient — RCPSC EM MCQ

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HardResuscitation, procedures, airwayDeterioration in an intubated trauma patientRCPSC EM

A 34-year-old man is intubated after a motorcycle crash and becomes profoundly hypoxic during transfer to the trauma bay. There is chest wall bruising, oxygen saturation is 74% and capnography confirms tracheal placement. Bagging is difficult with high resistance and equal chest rise is not seen. What is the most appropriate next step?

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Correct answer: C — Use the DOPE approach, disconnect the ventilator, pass a suction catheter and assess for pneumothorax or tube displacement

Sudden ventilated-patient deterioration requires immediate bedside troubleshooting: displacement, obstruction, pneumothorax and equipment failure. This should occur before transport imaging.

Reference: ATLS; Canadian airway management practice