In which scenario can the EMT remove an obstructed tracheostomy tube?

The removal of an obstructed tracheostomy tube is indicated when ventilation is not possible. In this critical scenario, the primary concern is to restore the patient's airway and ensure effective breathing. When ventilation is unsuccessful through the tube, it suggests that the airway is compromised, and attempting to relieve the obstruction or secure a new airway becomes necessary. Removing the tube may allow for clearing of the obstruction or the possibility of resuscitation efforts to restore airway patency.

In situations where ventilation is still effective, the tube should generally not be removed, as that could further complicate the situation. A conscious patient might be able to assist or indicate their needs, but the critical factor is whether ventilation is happening. The presence of another EMT may contribute support, but it does not alter the condition of the airway that necessitates tube removal.