SAQ 1508 – High airway pressures after prehospital intubation

Marked out of 16.00

A 30-year-old man is intubated at the scene after falling down stairs while intoxicated. In the ED, the registrar has difficulty ventilating him: airway pressures are high and the ventilator terminates inspiration at a tidal volume of 150 mL. You suspect aspiration lung injury.

Severe aspiration is confirmed. His pulse is 110/min, BP 110/70 mmHg, oxygen saturation 88%, and ABG shows pO2 55 mmHg and pCO2 65 mmHg. Ventilator settings are volume control, FiO2 1.0, tidal volume 500 mL, RR 12/min, PEEP 5 cmH2O, pressure limit 35 cmH2O, and I:E ratio 1:2.

List five other causes of this ventilation problem.

(Marked out of 5.0)


/ 5

List your initial actions to determine the cause.

(Marked out of 5.0)


/ 5

List three ventilator setting changes to improve oxygenation, and one adverse effect of each.

(Marked out of 6.0)


/ 6

Total Score: 0 / 16

Percentage: 0%