رجل عمره ٥٨ سنة في العناية على جهاز تنفس بسبب التهاب رئوي شديد، وعنده إفرازات كثيرة. أثناء شفط الأنبوب الحنجري، نزل التشبع من ٩٥٪ إلى ٨٦٪ وارتفع النبض من ٩٠ إلى ١٢٠، والمريض يسعل بقوة. ما التصرف الصحيح؟

A 58-year-old man in ICU is ventilated for severe pneumonia with copious secretions. During endotracheal suctioning SpO2 falls from 95% to 86%, HR rises from 90 to 120, and he coughs forcefully. What is the correct action?

1. Raise the suction pressure to 200 mmHg to finish faster
2. Instil saline into the tube to loosen secretions, then continue
3. Finish the pass quickly to clear the secretions within 15 seconds
4. Stop suctioning and give 100% oxygen before any further pass

Answer: D) Stop suctioning and give 100% oxygen before any further pass. Falling SpO2 and tachycardia mean suction-induced hypoxaemia, so stop at once and hyperoxygenate until the client recovers. Pressures above 120–150 mmHg injure the mucosa, and saline instillation is not recommended because it worsens hypoxaemia and infection risk.