Author Question: The therapist is about to establish a seal using the minimal leak technique with the cuff of an ETT. ... (Read 22 times)

dalyningkenk · **on:** Jul 16, 2018

The therapist is about to establish a seal using the minimal leak technique with the cuff of an ETT. Where should the therapist place the stethoscope to perceive the best sound detection?

A. directly over the thyroid cartilage
B. along either lateral aspect of the neck
C. immediately above the suprasternal notch
D. immediately above the thyroid cartilage

Question 2

While performing endotracheal intubation using an esophageal detection device, the therapist sees that the squeeze bulb attached to the 15-mm adapter of the endotracheal tube remains collapsed after the endotracheal tube has been advanced until the 23-cm mark on the tube is level with the patient's incisors. What should the therapist do at this time?

A. Secure the endotracheal tube in place with tape.
B. Advance the endotracheal tube further into the trachea until the tube's 28-cm mark is even with the patient's incisors.
C. Remove the ET tube, and attempt to reintubate the patient.
D. Withdraw the ET tube 4 or 5 cm, and tape the tube in position.

Mochi · **Reply #1 on:** Jul 16, 2018

Answer to Question 1

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: The minimal leak technique involves regulating the cuff inflation volume. This technique is intended to create a small leak around the cuff at end of inspiration. The therapist should place the stethoscope directly over the trachea immediately above the suprasternal notch. The minimal leak technique is used to maintain low ETT cuff pressures.
D. Incorrect response: See explanation C.

Answer to Question 2

ANS: C
A. Incorrect response: The endotracheal tube must not be secured with tape at this time.
B. Incorrect response: The ET tube appears to be placed at the correct depth because the 23-cm mark on the tube is level with the patient's incisors.
C. Correct response: The squeeze bulb should inflate when the endotracheal tube enters the trachea. Having the squeeze bulb remain collapsed (deflated) indicates that the ET tube has entered the esophagus. Therefore, the tube must be removed, and intubation must be reattempted. Once the tube is placed in the trachea, the common measures used to ascertain proper tube location must be performed.
D. Incorrect response: Withdrawing the ET tube 4 or 5 cm and taping it in place implies that the tube was in the trachea, but merely inserted too far. This action is inappropriate.