Adult Critical Care Specialty (ACCS) Practice Exam

What airway adjunct should be recommended for a patient with COPD after an exploratory laparotomy?

1. Tracheostomy

2. Hi-Lo Evac tube

3. Antibacterial coated endotracheal tube

4. Endobronchial tube

The correct answer is: Hi-Lo Evac tube

For a patient with COPD following an exploratory laparotomy, the recommendation of a Hi-Lo Evac tube is particularly relevant due to its design, which allows for effective management of secretions and improved ventilation. In patients with chronic obstructive pulmonary disease, there is often a risk of retaining secretions due to decreased airway clearance. The Hi-Lo Evac tube features a suctioning capability, which can help facilitate the removal of secretions and prevent complications such as atelectasis or pneumonia, which are significant concerns in this patient population. Additionally, the Hi-Lo Evac tube is suitable for patients who may need mechanical ventilation and assistance with airway management while also providing the necessary protection against aspiration. Considering the surgical context of an exploratory laparotomy, where respiratory function might be compromised due to anesthesia or postoperative status, this adjunct becomes even more critical for maintaining airway patency and respiratory hygiene. Other airway adjuncts, while applicable in specific scenarios, may not address the unique care needs of a COPD patient after surgery as effectively. For example, a tracheostomy is a more invasive intervention generally reserved for long-term airway management and would not typically be the first-line option immediately following surgery unless there are specific criteria indicating the need for permanent airway access. An antibacterial coated end