In troubleshooting inadequate ventilation for a patient with a tracheostomy, which action corresponds to the 'E' category in the DOPE mnemonic?

• A. Look for blood or other secretions in the tube.
• B. Attempt to pass a suction catheter into the tube.
• C. Check the mechanical ventilator for malfunction.
• D. Listen to breath sounds to assess for a pneumothorax.

Answer: (C)

The action shown targets equipment failure. In the DOPE framework for troubleshooting inadequate ventilation, four categories cover the likely causes: displacement of the tube, obstruction of the tube, pneumothorax, and equipment failure. The 'E' category specifically addresses problems with the ventilator and its circuit. Checking the mechanical ventilator for malfunction directly tests whether the apparatus delivering breaths isn’t working properly—things like power, alarms, settings, loose or broken tubing, or a disconnected circuit. If a hardware issue is found, fixing or replacing the equipment can restore ventilation. The other actions relate to the tube’s position or blockage (which would fall under displacement or obstruction) or to detecting a pneumothorax, rather than to the ventilator itself.