رجل عمره ٦٦ سنة بعد فغر الرغامى بيومين بسبب تهوية طويلة، والفتحة لم تتكون بعد. أثناء نوبة سعال قوية خرج الأنبوب بالكامل، والمريض قلق، والتشبع نزل إلى ٨٨٪، والتنفس ٣٠. ما التصرف الصحيح؟

A 66-year-old man had a tracheostomy two days ago after prolonged ventilation; the tract is not yet mature. During a forceful coughing fit the tube comes out completely; he is anxious, SpO2 drops to 88% and RR is 30. What is the correct action?

1. Force the tube back in whatever the resistance
2. Cover the stoma and wait for the surgeon without oxygen
3. Leave the stoma because it closes by itself within an hour
4. Call for help, give oxygen, prepare reinsertion with the obturator

Answer: D) Call for help, give oxygen, prepare reinsertion with the obturator. In the first days, before the tract matures, it can close quickly. Call for help, give oxygen and prepare reinsertion equipment and the bedside obturator. Never force it, as it may enter a false passage.