After endotracheal intubation, you suspect a right mainstem intubation. What is the correct immediate action?

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Multiple Choice

After endotracheal intubation, you suspect a right mainstem intubation. What is the correct immediate action?

When the endotracheal tube sits too far, the tip often drops into a mainstem bronchus, most commonly the right, causing ventilation of only the right lung. The immediate fix is to deflate the distal cuff and withdraw the tube slightly so the tip sits above the carina. This repositioning restores airflow to both lungs. After moving it, re-check bilateral breath sounds and chest rise, verify with capnography, and then reinflate the cuff and secure the tube. Leaving the tube in its current position continues one-lung ventilation and can worsen hypoxia, while removing the tube altogether or advancing it further would not quickly resolve the problem.

When the endotracheal tube sits too far, the tip often drops into a mainstem bronchus, most commonly the right, causing ventilation of only the right lung. The immediate fix is to deflate the distal cuff and withdraw the tube slightly so the tip sits above the carina. This repositioning restores airflow to both lungs. After moving it, re-check bilateral breath sounds and chest rise, verify with capnography, and then reinflate the cuff and secure the tube. Leaving the tube in its current position continues one-lung ventilation and can worsen hypoxia, while removing the tube altogether or advancing it further would not quickly resolve the problem.

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