Airway: early tracheostomy tube displacement: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Airway: early tracheostomy tube displacement

Sample item

On the second day after a surgical tracheostomy a patient pulls out the tube and becomes distressed and hypoxic. What is the safest immediate action?

AWait until the tract maturesBBlindly reinsert the tube through the stomaCOxygenate and attempt orotracheal intubation from above, as the stoma tract is immatureDInsert a nasogastric tube

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Oxygenate and attempt orotracheal intubation from above, as the stoma tract is immature

A tracheostomy tract takes about 5 to 7 days to mature, so early blind reinsertion can create a false passage into the pre-tracheal tissue. The safest approach is oxygenation by face mask to the mouth and stoma and orotracheal intubation. Stay sutures and a mature tract make replacement easier later.

Option by option

A. Wait until the tract matures
Waiting leaves the hypoxic patient without an airway.
B. Blindly reinsert the tube through the stoma
Blind reinsertion may enter the pretracheal tissue and fail.
C. Oxygenate and attempt orotracheal intubation from above, as the stoma tract is immature (correct)
Correct. Securing the airway from above avoids a false passage.
D. Insert a nasogastric tube
A nasogastric tube does not provide an airway.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this ENT question

What is the answer to this ENT question?

The best answer is C, Oxygenate and attempt orotracheal intubation from above, as the stoma tract is immature. A tracheostomy tract takes about 5 to 7 days to mature, so early blind reinsertion can create a false passage into the pre-tracheal tissue.

Why is "Wait until the tract matures" not the answer?

Waiting leaves the hypoxic patient without an airway.

Why is "Blindly reinsert the tube through the stoma" not the answer?

Blind reinsertion may enter the pretracheal tissue and fail.

Why is "Insert a nasogastric tube" not the answer?

A nasogastric tube does not provide an airway.

What concept does this question test?

It tests Airway: early tracheostomy tube displacement in ENT. The safest approach is oxygenation by face mask to the mouth and stoma and orotracheal intubation. Stay sutures and a mature tract make replacement easier later.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Airway: early tracheostomy tube displacement?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.