What is the most appropriate action when a ventilator-dependent patient's SpO2 decreases significantly and you hear coarse sounds in the ET tube?

The most appropriate action when encountering a ventilator-dependent patient with a significant decrease in SpO2 and the presence of coarse sounds in the endotracheal (ET) tube is to perform deep tracheal suctioning.

When coarse sounds are heard in the ET tube, it often indicates the presence of secretions or mucus that could be obstructing the airway, interfering with the patient's ability to ventilate properly. The decrease in SpO2 signifies that the patient may not be receiving sufficient oxygen, potentially due to airway obstruction from these secretions.

Deep tracheal suctioning helps to clear the airway, thereby restoring patency and improving ventilation and oxygenation. By removing the obstructive material, the patient can have improved lung function and oxygen levels indicated by a rise in SpO2.

Other options may not adequately address the immediate concern of airway obstruction. Increasing ventilator settings might temporarily improve ventilation but won't resolve the obstruction caused by secretions. Checking ET tube placement is critical if there's suspicion of dislodgment, but the presence of coarse sounds suggests a blockage rather than an issue with placement. Administering supplemental oxygen may increase oxygen delivery, but without addressing the underlying obstruction, it won't be an effective long-term solution and can lead