What is the initial step if the patient with a tracheostomy exhibits increased respiratory distress?

• A. Check the tracheostomy tube
• B. Position the patient upright
• C. Administer bronchodilators
• D. Obtain vital signs

Answer: (A)

When a patient with a tracheostomy exhibits increased respiratory distress, the initial and most crucial step is to check the tracheostomy tube. This involves assessing for any blockages or displacements that might be causing the distress. Given that the tracheostomy tube is an artificial airway, any issue with it can lead to significant respiratory compromise.

Obstructions could arise from secretions, kinks in the tubing, or even accidental decannulation. By checking the tube first, healthcare providers can quickly determine whether the airway is patent and can take immediate action to clear any obstruction or replace the tube if necessary.

Other options, such as positioning the patient upright, administering bronchodilators, or obtaining vital signs, are important steps in managing respiratory distress but should follow the assessment of the tracheostomy tube. If the airway is compromised, addressing it takes precedence over additional interventions, which may not be effective if the underlying issue is not resolved.