A 55-year-old firefighter presents at the hospital with 60% TBSA second- and third-degree burns…

A 55-year-old firefighter presents at the hospital with 60%
TBSA second- and third-degree burns after the successful rescue of an entire
family from their burning house. The patient is 6 feet, 2 inches and 240 lb.
During transport to the hospital he was intubated with an 8.0-mm ETT for
increased shortness of breath and changes in mental status. Breath sounds are
audible bilaterally. Ventilator settings are pressure support ventilation 15,
PEEP 5 cm H2O, and FiO2 0.5. The patient’s vital signs
are heart rate 110 beats/min, blood pressure 90/50 mm Hg, respiratory rate 30
breaths/ min, and SpO2 98%. Endotracheal suctioning shows moderate
dark/black secretions. The medical team started fluid resuscitation at a rate
of 1 L/hr of normal saline. An arterial line was placed in his right radial
artery, and the medical team has been struggling for the past half hour in the
emergency room to place a central line. His SpO2 has declined to
92%, but the other vital signs are unchanged. What should the RT do?

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