Final answer:
Immediate action is required when compliance deteriorates during bag-valve mask ventilation of an intubated patient. Checking for obstructions, repositioning, and ensuring equipment functionality can address this issue. It's necessary to follow health care-associated safety protocols to prevent complications.
Step-by-step explanation:
When you note that compliance is deteriorating while ventilating an intubated patient with a bag-valve mask, it is essential to take immediate action. Deteriorating compliance could be a sign of various issues such as pneumothorax, fluid accumulation in the chest, or a blockage in the tube. To address this, you should assess the patient for possible causes of decreased compliance, such as checking for disconnections or obstructions in the airway, auscultating the chest for equal breath sounds, and ensuring that the endotracheal tube is positioned correctly. If an obstruction, such as a mucus plug or aspirated object, is suspected, suction may be needed. In some cases, repositioning the patient might help improve lung expansion and compliance. Moreover, always remember to follow health care-associated safety protocols to prevent the introduction of bacteria via contaminated ventilators and ensure that devices are working properly, in line with manufacturers' instructions. Adjustments to ventilator settings may also be necessary to decrease the work of breathing and optimize ventilation-perfusion matching.