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Post-intubation breath stacking in asthma — RCPSC EM MCQ

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HardResuscitation, procedures, airwayPost-intubation breath stacking in asthmaRCPSC EM

A 22-year-old with status asthmaticus becomes hypotensive immediately after intubation. Ventilator shows high peak pressures, end-tidal CO2 is rising, and breath sounds are very quiet bilaterally. POCUS shows lung sliding and no pericardial effusion. What is the most appropriate next step?

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Correct answer: E — Disconnect the ventilator briefly and manually decompress for dynamic hyperinflation

Disconnect the ventilator briefly and manually decompress for dynamic hyperinflation is correct: the clues indicate Post-intubation breath stacking in asthma and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Critical care airway/ventilation practice