Question

A patient is being mechanically ventilated VC ventilation. A chest tube drainage system is in place and 1100 mL of fluid has been collected from the left chest. A low volume alarm on the ventilator begins to sound. The respiratory therapist notices vigorous bubbling in the water seal chamber. The following data is available:

pH 7.45 PaCO2 36 torr
PaO2 80 torr
HCO3- 24 mEq/L
BE -1 mEq/L
Mode Assist/control
VT 500 mL
Exhaled VT 296 mL
Mandatory rate 12/min
Total rate 10/min
FIO2 0.60
The respiratory therapist's first action should be to
A. decrease suction pressure to the system
B. discontinue chest tubes
C. increase rate to 14
D. look for a leak between the water seal chamber and the patient

Answer 1

The respiratory therapist's first action should be to look for a leak between the water seal chamber and the patient, which might be causing the vigorous bubbling and the low ventilator volume alarm.

Step-by-step explanation:

The student's question revolves around a mechanically ventilated patient experiencing a low-volume alarm and the observation of vigorous bubbling in the water seal chamber of a chest tube drainage system. When there is a discrepancy between the ventilator-set tidal volume (VT) and the exhaled VT, it's important to identify the cause, which in this scenario is likely due to a leak. The respiratory therapist's first action should be to look for a leak between the water seal chamber and the patient, as this could be the reason for vigorous bubbling in the water seal chamber and the discrepancy in tidal volumes.