Upon arriving at a residence for a patient with respiratory distress who is ventilator dependent, you should?

In a situation where a patient is experiencing respiratory distress and is dependent on mechanical ventilation, the most critical first step is to ensure that the patient is receiving adequate ventilation. Manually ventilating the patient can provide immediate support and may be necessary if there is an observable malfunction in the ventilator or if the patient is not effectively ventilated by the machine.

Manually ventilating the patient allows for real-time assessment of their response and can help prevent respiratory failure while troubleshooting any issues with the mechanical ventilator. If the patient is in distress, taking them off the ventilator to manually assist with ventilation ensures that they receive the necessary breaths as quickly as possible.

Checking the settings on the ventilator or suctioning the tracheostomy may be important subsequent steps, but the priority must be to stabilize the patient’s breathing first. Therefore, the action taken should address the immediate risk to the patient's respiratory status.