Florida State Paramedic Practice Exam

When sounds are heard only on the right side of an intubated patient, what should you do?

1. Continue ventilation

2. Administer medication

3. Pull back on the tube slightly and listen again

4. Insert a second tube to the left

The correct answer is: Pull back on the tube slightly and listen again

Hearing breath sounds only on one side of an intubated patient indicates that the endotracheal tube may be malpositioned, likely in the right mainstem bronchus. In such a situation, a practical and immediate response is to reassess the tube's position. Pulling back slightly on the tube allows for a repositioning that may help ensure proper ventilation to both lungs. Listening again afterward provides crucial feedback to confirm that airflow has improved and is now symmetrical, ensuring the patient is receiving adequate oxygenation from both lung fields. Continuing ventilation without evaluating the tube placement may result in inadequate ventilation to the left lung, which could lead to serious complications. Administering medication does not address the primary concern of airway management in this scenario, as the issue at hand is related to tube placement rather than the need for pharmacological intervention. Inserting a second tube may complicate the situation further without first confirming the need for repositioning the existing tube. Therefore, the correct approach is to adjust and verify the tube's position, ensuring effective ventilation and minimizing risks.