A patient with a tracheostomy tube is receiving positive-pressure ventilation through a volume ventilator

Over the past 5 min, the peak inspiratory pressure has risen, and the pressure limit alarm is now sounding. On quick examination, you notice a generalized decreased in breath sounds. Which of the following problems is most likely?
a. Partial obstruction of the tracheostomy tube
b. Complete obstruction of the tracheostomy tube
c. Development of a left-sided pneumotho-rax
d. Obstruction of the left bronchus by a mu-cus plug


ANS: A
A spontaneously breathing patient with partial airway obstruction will exhibit decreased breath sounds and decreased airflow through the tube. If the patient is receiving volume-controlled ven-tilation, peak inspiratory pressures will rise, often causing the high-pressure alarm to sound; dur-ing pressure-controlled ventilation, delivered tidal volumes will fall.

Health Professions

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