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Problem: The patient experiences an abrupt deterioration (with a rapid rise in PaCO
while being mechanically ventilated with the high frequency oscillator.
Consider the following:
•
Acute airway obstruction (mucous plug)
•
Bronchospasm
Responses under these circumstances:
•
Assess airway function/patency (e.g., ETT suctioning, auscultation, direct
laryngoscopy, tcPCO
•
Recommend bronchoscopy
•
Draw an ABG if the acute decompensation results in profound hypoxemia
(SpO
< 80%) or acute hypotension (mean BP drop of > 20 mmHg)
2
•
Notify the physician of these developments immediately and recommend a "stat"
chest x-ray
•
Consider removing the patient from the oscillator and hand resuscitating
assessment, diminished chest wiggle)
2
•
Pneumothorax
•
Right mainstem intubation
or extubation
25
)
2
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