thought patient first before machine?

[louiseraphelle]

I encounter a question like a patient has a Sengstaken-Blakemore tube in place. woman in respiratory distress.

>elevate the head of the bed and administer oxygen OR

> cut the balloon ports and remove the tube.THIS IS THE RIGHT ONE HOW COME??

[Nurse7970]

SB tubes that do their job "too well" can rupture the esophagus... Leading into respiratory distress... And shock also is an outcome.

Think about it in the sense of "if I can do one action that will immediately improve the most dire situation which will it be?" Cutting the tube is your quickest intervention with the most positive outcome.

[DBK99]

Establish the airway 1st. Cut the tube

[HouTx, BSN, MSN, EdD]

This is one of those questions where critical thinking is key. Your initial reaction was to automatically apply the "patient before equipment" rubric - under the assumption that this is always applicable. Apply critical thinking by questioning your underlying assumptions first. Are there some instances in which you should deal with the equipment first? When would you do this? When you "know" (based on experience & knowledge) that the equipment is causing the patient problem, right?

Following that line of reasoning - and knowing how S-B tubes are constructed & how they work. .. what should you do to alleviate the patient's respiratory distress? Yeah, that's right -the resp distress is being caused by the S-B tube so you have to get it outta there ASAP because the patient is more likely to suffer immediate harm from lack of oxygen than from bleeding varices.

[louiseraphelle]

Thanks guyz now I know I should think very critically from now on then.Thank you I'll practice mpre everyday :) Goodluck to me I'll takr mine in amonth super anxious rn.. :"(