When a ventilated patient experiences a high pressure alarm due to tube obstruction or biting the tube, what is an appropriate immediate nursing action?

• A. Check patient comfort and reposition
• B. Call for physician immediately and wait
• C. Discontinue ventilation
• D. Increase sedation and suctioning

Answer: (D)

When a high pressure alarm sounds in a ventilated patient, the message is that there’s increased airway resistance or an obstruction in the circuit. The fastest way to restore ventilation is to relieve the blockage and reduce fighting against the ventilator. Increasing sedation helps because it decreases patient-ventilator asynchrony and stops biting or agitated efforts that raise airway pressures. Suctioning is crucial because it clears secretions or mucus plugging that can obstruct the endotracheal tube and further raise resistance.

So, addressing both parts—calming the patient to stop tube-biting and clearing the airway with suction—directly targets the common causes of a high pressure alarm. While comfort checks or repositioning are important, they may not resolve the obstruction quickly. Immediate suctioning plus increased sedation tackles the problem now, with escalation to other steps if the alarm persists.