What should a neonatal/pediatric specialist do if the PETCO2 monitor reads zero after re-taping an endotracheal tube?

When a PETCO2 monitor reads zero after re-taping an endotracheal tube, this indicates that there is likely no ventilation occurring through the tube. A reading of zero suggests that carbon dioxide is not being detected in the exhaled breath, which can be due to several scenarios, such as the tube being misplaced in the esophagus instead of the trachea, or complete dislodgement.

In this situation, the most appropriate action is to remove the endotracheal tube. This is critical to ensure safety and to prevent any potential complications associated with incorrect placement. If the tube is in the wrong position—such as in the esophagus—continuing to ventilate could lead to inadequate oxygenation and potential respiratory compromise for the infant or child.

Other options such as advancing the endotracheal tube could further complicate the situation if the tube is misplaced. Suctioning the endotracheal tube may only be relevant if there is suspicion of blockage or secretions while the tube is still functioning correctly. Ordering a chest x-ray would be used for confirmation of placement, but it doesn't address the immediate concern of improper tube position. Therefore, removing the endotracheal tube is the most immediate and appropriate response to a