Trauma Nurse Core Course (TNCC) Practice Exam

What is the priority intervention for an intubated trauma patient whose pulse oximetry drops to 85% during transfer?

1. Call for a portable CXR stat

2. Chest to make sure the ventilator is plugged in

3. Suction the ET tube

4. Confirm ET tube placement

The correct answer is: Confirm ET tube placement

In the case of an intubated trauma patient whose pulse oximetry drops significantly to 85%, the priority intervention is to confirm the correct placement of the endotracheal (ET) tube. A drop in oxygen saturation in an intubated patient can indicate that the tube may be dislodged, leading to inadequate ventilation and oxygenation. When the ET tube is not properly positioned—whether it has been inadvertently pulled out, displaced, or placed incorrectly—it can prevent effective ventilation of the lungs. Confirming ET tube placement ensures that the airway is secure and that the patient is receiving appropriate oxygenation. The use of methods such as auscultation of breath sounds bilaterally, observing for symmetrical chest expansion, and checking for the presence of end-tidal carbon dioxide (if available) are crucial steps in confirming the placement before considering other interventions. While suctioning the ET tube or checking equipment like a ventilator is important in other scenarios, ensuring that the airway is secure is paramount in this situation to prevent further deterioration of the patient's condition.