Breathing Asynchronously with the Ventilator (TMC Practice Question)

1 year ago
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The video breaks down a sample TMC practice question about a patient who is breathing asynchronously with the mechanical ventilator. Do you know the correct answer?
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➡️ Question:
A 58-year-old female patient is intubated and appears to be breathing asynchronously with the ventilator. Her breath sounds are absent on the left side, and the trachea is shifted to the left. The patient has a dull percussion note on the left side as well. Which of the following is the most likely explanation for these findings?
A. A tracheoesophageal fistula has developed
B. A tension pneumothorax has developed on the left side
C. The endotracheal tube is in the right mainstem bronchus
D. The patient is experiencing diffuse bronchospasm

To get this one correct, you needed to be able to interpret the information that was provided in the question. It states that the patient has a dull percussion note on the left side, a tracheal shift toward the left side, and absent breath sounds on the left side. Therefore, you needed to recognize that these are all signs of atelectasis. So, now you have to think, "what could possibly be the cause of this atelectasis?" And in this case, the endotracheal tube has likely slipped into the right mainstem bronchus, which has resulted in left-sided atelectasis. Diffuse bronchospasm would cause bilateral wheezing, and a left-sided pneumothorax would cause a hyperresonant percussion note, not a dull percussion note.

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This content is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please consult with a physician with any questions that you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you watch in this video. We strive for 100% accuracy, but errors may occur, and medications, protocols, and treatment methods may change over time.

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⏰TIMESTAMPS
0:00 - Intro
0:34 - Practice Question
1:12 - Explanation
2:06 - Correct Answer

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