مريض على جهاز تنفس، ولاحظ الممرض أن رقم الأنبوب عند الشفة صار ١٩ سم بعد أن كان ٢٣ سم، وأصوات التنفس ضعيفة في اليسار. ما الأرجح؟

In a ventilated client the tube marking at the lip is now 19 cm instead of 23 cm, with reduced breath sounds on the left. What is most likely?

1. The tube has advanced into the right main bronchus
2. The tube is exactly in the right place
3. A cuff leak only, without tube movement
4. The tube has partly come out upward

Answer: D) The tube has partly come out upward. A lower number at the lip means the tube has been pulled out, possibly with the cuff at the cords. Assess and report at once. A deeper tube increases the number and usually reduces left-sided sounds.