Clinical scenario based on real life situation:
A patient is vented through ETT #6.5 suddenly drops to SpO2 25% and is showing a consistent good waveform. The patient who was comatose, now opens his eyes and his face is turning grey. Vent shows extremely low TV.
What have you got? What do you do? What do you order?
- Mucous plug
1. Call for help (respiratory, etal.)
2. Attempt to suction. If that does not resolve the issue move to the next step
2. Grab an Abmu to connect to the ETT and ventilate despite resistance
3. Once help arrives, you may connect O2 and crank it up. Use a saline lavage while ventilating and inline suction.
Post intervention:
STAT ABG and portable Chest Xray
Encourage a frequent tracheobronchial toileting
Consider ordering Mucomyst (Acetylcysteine) and bronchodilators.
P.S. I saved a life on Thanksgiving day and hope that the concept of this scenario will save another.
