The RT responds to the high pressure,high respiratory rate,low exhaled volume,and low exhaled minute volume alarms of a mechanically ventilated patient in the ICU.Upon entering the room,the RT notices that the patient,who is still attached to the ventilator,appears diaphoretic,tachypneic,tachycardic,and hypertensive.Breath sounds are absent on the left and distant on the right.The patient's trachea is deviated to the left,and jugular vein distention is present.The endotracheal tube is 24 cm at the teeth.Immediate action should include which of the following?

Question

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The ringing of the high pressure alarm for a time has led to the sounding of the low volume and low minute volume alarms.The patient is in apparent respiratory distress,as evidenced by the tachypnea,tachycardia,and diaphoresis.The position of the ET tube at the 24-cm mark is evidence that the tube has slipped into the right mainstem bronchus.However,the absence of breath sounds on the left plus the tracheal deviation to the left,along with the jugular vein distention,is evidence of a tension pneumothorax on the right side.The ET tube appears to have slipped into the right mainstem bronchus and subsequently caused a pneumothorax.This is a life-threatening situation,and the pneumothorax must be decompressed immediately with a 14-gauge needle inserted into the second or third intercostal space on the right midclavicular line.

The RT Responds to the High Pressure,high Respiratory Rate,low Exhaled