DOPE ALGORITHM- MANAGING A DETERIORATING VENTILATED INFANT
Assessing Ventilation in Infants: The DOPE Algorithm
Welcome to the DOPE Algorithm quiz, designed for healthcare professionals to enhance their understanding of managing deteriorating ventilated infants.
Test your knowledge and skills with questions covering key concepts such as:
- The meaning of the DOPE acronym
- Initial assessments for ventilated infants
- Signs of tube dislodgment and pneumothorax
- Appropriate actions in case of equipment failure
What does the acronym DOPE stand for?
Displacement, Observations, Pneumothorax, Extubation
Displacement, Obstruction, Pneumothorax, Equipment
Disengagement, Obstruction, Pneumonia, Equipment
Disintegration, Obstruction, Pneumothorax, Extubation
You are looking after a baby on conventional ventilation, what initial assessments would you do at the beginning of your shift? Tick ALL that applies.
Check the ETT size and lip level and make sure it is the same as the documented level.
No need to do check at the beginning of the shift to minimise handling-ETT assessment to be done with the next set of cares.
Assess for equal and symmetrical chest rise.
Auscultate for bilateral air entry
Verify the ventilator settings
Check for ETCO2 tracing
Ascertain if your ETT is properly secured.
Which of the following are indicative that the tube is dislodged?
Sudden clinical deterioration with decrease in heart rate and oxygen saturation
Loss of chest wall movement with Increase in leak noted by ventilator
Loss of end tidal CO2 detection
Equal, bilateral air entry on both lung fields
Audible cry
Loss of air entry sounds on auscultation
ETT suctioning is a routine process that needs to be performed on a ventilated baby on a regular basis to prevent tube obstruction.
True
False
Which of the following symptoms would make you suspect pneumothorax in a ventilated infant?
Sudden deterioration in the infant's clinical state
Equal, bilateral air entry.
Sudden deterioration in the infant's clinical state Marked respiratory distress
Decreased air entry on the affected side
Tracheal deviation to the contralateral site of the pneumothorax
Pidgeon chest appearance
Choose TWO statements that are accurate with regards to diagnosing pneumothorax:
Transillumination of the chest is a traditional but innacurate technique of diagnosing pneumothorax.
Transillumination of the chest with an intense beam of light is a useful method of making the diagnosis in an emergency
Confirmation by x-ray only if the infant is stable. If the infant is unstable, immediate draining of air is imperative.
It is imperative to perform chest xray to confirm the diagnosis of pneumothorax regardless if the baby is unstable for the procedure. Correct diagnosis outweighs this risk.
In case of an equipment failure, which of the following steps are appropriate? Tick ALL that applies.
Disconnect from ventilator and bag/neopuff manually
Call for help
Check other equipment, lines, tubing, etc.
Do not disconnect from the ventilator as it increases the risk of dislodging the tube,
Check for ventilator malfunction, interruption to gas supply
You approached your baby as the monitor alarmed, HR 49 Saturation 25%. Baby appears dusky with no respiratory effort, no air entry, no chest rise and no EtCO2 tracing. The ETT was secured at LL6 but is now at LL 4. What will you do?
Do not remove the tube and perform positive pressure ventilation with a mask, on top of the ETT.
Remove the tube and perform positive pressure ventilation with a mask.
Do not remove the tube until a member of the medical team arrives.
Try to replace the tube and push it back to LL 6.
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