If a patient with respiratory distress has foreign body obstruction and the ETT insertion was unsuccessful, what would be the NEXT anticipated procedure?

In a scenario where a patient with respiratory distress is experiencing foreign body obstruction and attempts to insert an endotracheal tube (ETT) have failed, the appropriate subsequent procedure is a tracheostomy. This procedure provides immediate access to the airway and allows for ventilation, bypassing the obstructed area in the upper airway.

A tracheostomy creates an opening directly in the trachea, which enables the medical team to secure the airway quickly and effectively, particularly in cases where the obstruction is severe and prolonged. This is crucial in emergency settings, as restoring adequate airflow is vital for patient survival.

Other methods, such as the placement of a laryngeal mask or bronchoscopy, may be considered in different situations but are not the immediate response when ETT insertion fails in the context of a life-threatening airway obstruction. A chest tube insertion pertains to issues with intrathoracic pressure or fluid in the pleural space, which are not applicable in this scenario where the primary problem is upper airway obstruction. Thus, tracheostomy becomes the most appropriate and efficient intervention following the unsuccessful attempt at intubation.