Deterioration after intubation

Diagnosis

• DOPE
  • D - Displaced ETT
  • O - Obstructed ETT
  • P - Pneumothorax
  • E - Equipment failure (ventilator malfunction or disconnect)

Management

• When in doubt, disconnect the pt from the ventilator and begin bag ventilation
  • Eliminates the vent (E) circuit as source of the problem
  • Helps gauge lung compliance
• Airway
  • Is the tube still in? (D)
  • Is it patent? (O)
  • Auscultate and/or CXR
• Breathing
  • Is the chest rising? Breath sounds equal b/l? (P)
    • Lung sounds not always reliable → get CXR if continued clinical concern

See Also

• Intubation