When suctioning a 46-year-old male with a tracheostomy tube, which procedural step is appropriate?
A) Introduce the suction catheter into the tracheostomy tube by first inserting it into the mouth or nose and then threading it lower
B) Suction no more than 5 seconds using a hard-tipped suction
C) Introduce 20 mL of sterile water into the tracheostomy tube prior to suctioning
D) Insert the soft suction cannula until mild resistance is met and then initiate suction
D) Insert the soft suction cannula until mild resistance is met and then initiate suction
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All honorably discharged veterans are eligible for free medical care for life at Veterans Affairs health care facilities
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A 33-year-old man was burned when the hot water heater he was working on exploded. The patient has superficial and partial-thickness burns to his face, neck, and arms. Your primary assessment reveals that he is restless and tachypneic. His BP is 80/54 mm Hg and his heart rate is 120 beats/min and weak. You should:
A) conclude that he is experiencing burn shock, start two large-bore IV lines of normal saline, and administer fluids based on the Parkland formula. B) assist his ventilations with a bag-mask device, cover him with a blanket, and start a large-bore IV of normal saline set at a keep vein open rate. C) apply oxygen via nonrebreathing mask, cover his burns with cold moist dressings, start an IV with normal saline, and give up to 4 mg of morphine for pain. D) administer high-flow oxygen, keep him warm, start at least one large-bore IV of normal saline, and administer fluid boluses to maintain adequate perfusion.