The volume curve on a volume-time scalar is consistently dropping below the baseline during ex-halation. The first action to take is which of the following?

a. Measure the plateau pressure.
b. Measure the endotracheal (ET) tube cuff pressure.
c. Check the ventilator circuit for a leak.
d. Assess the patient for active exhalation.

ANS: D
When the volume drops below the baseline during exhalation, the cause could be active exhala-tion or an inspiratory time that is too long. Assessing the patient for active exhalation is the only viable answer given the choices. By doing the assessment the respiratory therapist can determine whether active exhalation is the cause.