ACLS Airway Management & Ventilation 2 — Questions and Answers
Question 1: What is the primary sign of gastric inflation during bag-mask ventilation?
- Visible chest rise with each breath
- Increasing abdominal distension (Correct answer)
- Decreased airway resistance felt in the bag
- Improved SpO2 readings
Correct answer: Increasing abdominal distension
Gastric inflation is identified by progressive abdominal distension and can lead to regurgitation and aspiration.
Question 2: What is the recommended pre-oxygenation approach before attempting endotracheal intubation in ACLS?
- Nasal cannula at 2 L/min for 1 minute
- Non-rebreather mask at 15 L/min for 3 minutes (Correct answer)
- Room air for 2 minutes
- Simple face mask at 8 L/min for 1 minute
Correct answer: Non-rebreather mask at 15 L/min for 3 minutes
A non-rebreather mask at 15 L/min for at least 3 minutes maximizes oxygen reserve by denitrogenating the lungs before intubation.
Question 3: What is the Sellick maneuver and its purpose during endotracheal intubation?
- Upward pressure on the thyroid to improve vocal cord view
- Backward pressure on the cricoid to occlude the esophagus and reduce aspiration risk (Correct answer)
- Jaw thrust to open the airway prior to laryngoscopy
- Downward tongue depression to visualize the glottis
Correct answer: Backward pressure on the cricoid to occlude the esophagus and reduce aspiration risk
The Sellick maneuver applies backward pressure on the cricoid cartilage, occluding the esophagus to potentially reduce passive regurgitation during intubation.
Question 4: For a patient with a mature tracheostomy in cardiac arrest, what is the first step in airway management?
- Insert an oropharyngeal airway
- Attempt ventilation directly through the tracheostomy stoma (Correct answer)
- Perform orotracheal intubation through the mouth
- Apply a face mask over the mouth and nose
Correct answer: Attempt ventilation directly through the tracheostomy stoma
Ventilation through a mature tracheostomy stoma provides the most direct access to the trachea and should be the first approach.
Question 5: During CPR, a sudden and sustained rise in ETCO2 from 15 to 40 mmHg most likely indicates:
- Worsening cardiac output
- Return of spontaneous circulation (ROSC) (Correct answer)
- Correct ETT placement confirmation
- Accidental hyperventilation
Correct answer: Return of spontaneous circulation (ROSC)
A sudden sustained rise in ETCO2 is a reliable indicator of ROSC, as restored cardiac output delivers significantly more CO2 to the lungs.
Question 6: What is the maximum recommended duration of a single endotracheal intubation attempt before resuming ventilation?
- 10 seconds (Correct answer)
- 20 seconds
- 30 seconds
- 45 seconds
Correct answer: 10 seconds
Each intubation attempt should be limited to 10 seconds to minimize hypoxia; if unsuccessful, resume oxygenation before the next attempt.
Question 7: Which device can provide a definitive airway for ventilation without requiring direct visualization of the vocal cords?
- Oropharyngeal airway (OPA)
- Nasopharyngeal airway (NPA)
- King LT supraglottic airway (Correct answer)
- Magill forceps
Correct answer: King LT supraglottic airway
The King LT and similar supraglottic airways can be inserted blindly and allow effective ventilation without direct laryngoscopy.
ACLS Airway Management & Ventilation 2
What is the primary sign of gastric inflation during bag-mask ventilation?