Chapter 29: Question 1
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29.1 You are called to urgently review a 4-hour-old 25-week infant who is ventilated for respiratory distress syndrome. Prior to this episode she was in 30% oxygen on SIPPV + VG and needed pressures of 20/6 to obtain a tidal volume of 4 mL/kg. She is now in 100% oxygen and the ventilator is alarming due to the maximum pressure limit being reached (currently set at 25 cmH2O). On examination you notice that the right chest is full and there is decreased air entry on the right compared to the left. The trachea is deviated to the left. His pulse rate is now 80 beats per minute and oxygen saturations are in the 70s. Which one of the following is the appropriate next step in management?
