A 71-year-old male with a tracheostomy is cyanotic and has audible gurgling sounds. What should you do next?

A 71-year-old male with a tracheostomy is cyanotic and has audible gurgling sounds. What should you do next?

• A. Administer bronchodilator
• B. Perform mouth-to-mouth rescue breaths
• C. Suction the lumen with a soft tip catheter
• D. Insert a new tracheostomy tube

Answer: (C)

In this scenario, the patient's cyanosis and audible gurgling suggest that there is an obstruction in the airway, likely caused by secretions or other debris blocking airflow through the tracheostomy. The immediate priority in such cases is to ensure the patient can breathe adequately. Suctioning is an essential intervention that helps clear the airways, allowing better airflow and improving oxygenation. Using a soft tip catheter to suction the lumen is appropriate because it enables the removal of secretions safely and effectively. This action can alleviate both the gurgling sounds and the cyanosis, which indicates hypoxia due to possible airway obstruction. While other options may have their place in different clinical situations, they are not the most suitable immediate response in this case. Administering a bronchodilator would not address the obstruction directly and could delay the necessary steps to clear the airway. Performing mouth-to-mouth rescue breaths is not appropriate for a patient with a tracheostomy, as the airway management technique differs significantly. Inserting a new tracheostomy tube may be necessary if suctioning does not resolve the issue, but it is a more invasive step that should follow immediate clearance of the airway with suctioning. Therefore, suctioning the lumen with a

In this scenario, the patient's cyanosis and audible gurgling suggest that there is an obstruction in the airway, likely caused by secretions or other debris blocking airflow through the tracheostomy. The immediate priority in such cases is to ensure the patient can breathe adequately. Suctioning is an essential intervention that helps clear the airways, allowing better airflow and improving oxygenation.

Using a soft tip catheter to suction the lumen is appropriate because it enables the removal of secretions safely and effectively. This action can alleviate both the gurgling sounds and the cyanosis, which indicates hypoxia due to possible airway obstruction.

While other options may have their place in different clinical situations, they are not the most suitable immediate response in this case. Administering a bronchodilator would not address the obstruction directly and could delay the necessary steps to clear the airway. Performing mouth-to-mouth rescue breaths is not appropriate for a patient with a tracheostomy, as the airway management technique differs significantly. Inserting a new tracheostomy tube may be necessary if suctioning does not resolve the issue, but it is a more invasive step that should follow immediate clearance of the airway with suctioning.

Therefore, suctioning the lumen with a