65 year old man with prolonged recovery from ARDS, requiring continued mechanical ventilatory support, who underwent percutaneous tracheostomy insertion 10 days ago. Learner is called to the bedside by the MICU nurse due to hypoxia and a low pressure alarm on the ventilator. Learner should examine the patient and ventilator and determine that there is a cuff leak. They should then try to inflate the cuff, which will be unsuccessful. They should then be able to safely remove and replace the tracheostomy in order to stabilize the patient.
Nurse Practitioner, Paramedic, Physician, Physician Assistant, Respiratory Therapist
Anesthesiology, Emergency medicine, ENT, Internal medicine, Pulmonology