What immediate action should a therapist take when a nasally intubated patient experiences a sudden drop in SpO2 from 97% to 82%?

• A. Insert chest tubes in the right chest
• B. Manually ventilate the patient with a bag-valve
• C. Increase FIO2 to 1.0
• D. Increase the pressure limit of the ventilator

Answer: (C)

In the context of a nasally intubated patient experiencing a sudden drop in oxygen saturation (SpO2) from 97% to 82%, the most appropriate immediate action is to increase the fractional inspired oxygen (FIO2) to 1.0. This step is crucial because a significant drop in oxygen saturation indicates that the patient is not receiving adequate oxygen, potentially due to factors such as airway obstruction, inadequate ventilation, or changes in lung perfusion.

Increasing the FIO2 to 1.0 provides the highest concentration of oxygen available, which can rapidly improve the oxygenation status of the patient. It is an essential first response in emergencies where hypoxemia is evident, especially before conducting further assessments or interventions.

While other options might be necessary in a comprehensive management plan, they are generally not the immediate first step compared to maximizing oxygen delivery. For instance, manually ventilating the patient with a bag-valve is a potential response if ventilation is inadequate, but the priority should be ensuring adequate oxygen levels quickly. Other measures like inserting chest tubes could be warranted in cases of pneumothorax or significant pleural effusion but are not indicated based solely on a drop in SpO2. Increasing the pressure limit of the ventilator