ABA Safety Protocols & Risk Management 3

Question 1

When using a pulse oximeter, which hemoglobin species causes falsely HIGH SpO2 readings in cases of carbon monoxide poisoning?

Accepted Answer

Carboxyhemoglobin

Answer

Carboxyhemoglobin (COHb) absorbs light similarly to oxyhemoglobin at 660 nm, causing pulse oximetry to overestimate true SaO2.

Question 2

A 45-year-old patient receives 3 g of bupivacaine IV in error. Which treatment is most specific to reverse cardiac toxicity?

Accepted Answer

Intralipid 20% 1.5 mL/kg IV bolus

Answer

Intralipid (lipid emulsion therapy) is the specific antidote for local anesthetic systemic toxicity (LAST) cardiac arrest.

Question 3

Correct sequencing of the five steps in a pre-use anesthesia machine checkout (per FDA 1993) begins with:

Accepted Answer

Verification of backup ventilation equipment

Answer

The FDA checkout recommends verifying that backup ventilation (e.g., self-inflating bag) is available and functional as the first step.

Question 4

Which monitoring modality is most appropriate to guide goal-directed fluid therapy and detect occult hypovolemia intraoperatively?

Accepted Answer

Pulse pressure variation (PPV)

Answer

PPV >13% in mechanically ventilated patients with sinus rhythm reliably predicts fluid responsiveness for goal-directed therapy.

Question 5

Under which condition is cricoid pressure (Sellick maneuver) CONTRAINDICATED?

Accepted Answer

Patients with known cervical spine instability

Answer

Cricoid pressure is contraindicated in patients with cervical spine instability because it can displace the spine and worsen neurological injury.

(ABA) ASA (American Society of Anesthesiologists) Board Certification Practice Test