A patient who self-extubated is experiencing inspiratory stridor. What additional action should the respiratory therapist consider?

• A. Immediately reintubate the patient
• B. Provide heated mist
• C. Examine the oropharynx with a tongue depressor
• D. Administer aerosolized racemic epinephrine

Answer: (D)

In cases of inspiratory stridor following extubation, administering aerosolized racemic epinephrine is particularly beneficial because it acts as a bronchodilator and helps to reduce airway swelling. Stridor generally indicates upper airway obstruction or inflammation, which can occur if there is edema or vascular engorgement post-extubation. Racemic epinephrine works quickly to relieve airway swelling and improve airflow, making it a crucial intervention in this scenario.

Additionally, while the other actions may have their merits depending on the specific situation or severity, aerosolized racemic epinephrine is focused directly on mitigating the acute symptoms of stridor and preventing further complications. This makes it a more immediate priority compared to reintubation, which may involve additional risks, or simply providing supportive measures like heated mist, which might not address the underlying cause effectively and promptly. Examining the oropharynx is important but would typically come after ensuring that immediate airway management is addressed.