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Ventilated transfer with rising CO2 — DipIMC MCQ

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HardRetrieval MedicineVentilated transfer with rising CO2DipIMC

A ventilated intubated trauma patient is being transferred by road. Thirty minutes into the journey, SpO2 falls from 98% to 91%, peak airway pressure rises, end-tidal CO2 falls abruptly and unilateral breath sounds are reduced. What is the most appropriate management?

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Correct answer: B — Stop safely, check the tube and decompress the chest if tension is suspected

Sudden hypoxia with high airway pressure, falling end-tidal CO2 and unilateral signs suggests obstruction, displacement or tension pneumothorax. The vehicle should stop safely for immediate ABC troubleshooting and decompression if indicated. Continuing without assessment risks arrest during transfer.

Reference: Association of Anaesthetists transfer principles; JRCALC Guidelines