If a patient with an ET tube is audibly speaking, what is the first action you should take?

When a patient with an endotracheal (ET) tube is audibly speaking, the first action should be to check the cuff. The cuff of the ET tube is designed to create a seal within the trachea, preventing airflow from escaping around the tube and ensuring that ventilation is effective. If the cuff is not properly inflated, the patient may have inadequate airway protection and could be at risk for aspiration. Additionally, if the cuff is deflated, the patient may be able to speak, but this may compromise their ability to ventilate effectively and maintain adequate oxygenation.

Checking the cuff ensures that it is inflated to the appropriate level, thereby maintaining the integrity of the airway and ensuring that the patient receives proper ventilatory support. Only after ensuring the cuff is functioning correctly should further actions be considered if necessary, such as notifying a physician or adjusting other ventilatory settings.