If a patient on Pressure Support Ventilation (PSV) exhibits an increased inspiratory time, what should the respiratory therapist do first?

• A. Change to the SIMV mode.
• B. Check the endotracheal tube cuff pressure.
• C. Increase the inspiratory flow setting.
• D. Suction and lavage the patient's airway.

Answer: (B)

In a scenario where a patient on Pressure Support Ventilation (PSV) exhibits an increased inspiratory time, the best initial action is to check the endotracheal tube cuff pressure. This step is crucial because an improperly inflated cuff can lead to increased resistance during ventilation, making it difficult for the patient to initiate and maintain adequate breaths. If the cuff pressure is too high or too low, it can affect airflow and pressure dynamics, leading to changes in the patient's breathing pattern, including prolonged inspiratory times.

By checking the cuff pressure, the respiratory therapist can ensure that the airway is adequately sealed and that there are no leaks affecting ventilation. Maintaining the appropriate cuff pressure is essential for optimal ventilatory support and can directly impact the effectiveness of Pressure Support Ventilation. This assessment lays the foundation for further interventions if necessary, ensuring the patient's needs are met without taking unnecessary steps that may complicate the situation further.