AEMCA - Advanced Emergency Medical Care Assistant Airway Management and Ventilation Questions and Answers

Question 1

A 68-year-old male with a history of COPD is found in respiratory distress. He is obtunded, has a respiratory rate of 8 breaths per minute, and his skin is cyanotic. Waveform capnography shows a 'shark fin' appearance. What is the most likely cause of this waveform?

Accepted Answer

Bronchospasm

Answer

The 'shark fin' capnography waveform is characteristic of bronchospasm. This shape is caused by uneven and prolonged alveolar emptying due to airway obstruction, which is common in patients with COPD or asthma exacerbations. The upstroke of the waveform has a sloped appearance rather than the normal steep, almost vertical angle.

Question 2

When ventilating an apneic adult patient with an advanced airway in place, what is the correct ventilation rate according to current guidelines?

Accepted Answer

1 breath every 6 seconds (10 breaths/min)

Answer

According to the most recent CPR and ECC guidelines, when an advanced airway (such as an endotracheal tube or supraglottic airway) is in place, ventilations should be delivered at a rate of 1 breath every 6 seconds, which equates to 10 breaths per minute for an adult patient. This avoids the complications of hyperventilation.

Question 3

Which of the following is considered the most reliable method for confirming initial and ongoing placement of an endotracheal tube in a patient with a perfusing rhythm?

Accepted Answer

Continuous waveform capnography

Answer

Continuous waveform capnography is the gold standard for confirming and monitoring endotracheal tube placement. It provides real-time, breath-to-breath analysis of expired CO2, which is the most reliable indicator that the tube is in the trachea and not the esophagus. Other methods like auscultation, chest rise, and EDD are useful secondary confirmation techniques but are not as definitive.

Question 4

You are managing a patient following a traumatic injury and suspect a cervical spine injury. The patient is unconscious and requires airway management. Which manual maneuver is most appropriate for opening the airway in this patient?

Accepted Answer

Jaw-thrust maneuver

Answer

In a patient with a suspected cervical spine injury, the jaw-thrust maneuver is the recommended technique for opening the airway. This method avoids extending or flexing the neck, minimizing the risk of exacerbating a potential spinal cord injury. The head-tilt, chin-lift is contraindicated in this scenario.

Question 5

A paramedic has made three unsuccessful attempts at endotracheal intubation on an apneic patient. Oxygen saturation is being maintained at 94% with bag-valve-mask ventilation between attempts. According to difficult airway algorithms, what is the appropriate next step?

Accepted Answer

Declare a failed airway and proceed to a rescue airway device (e.g., SGA)

Answer

A failed airway is often defined as three unsuccessful intubation attempts by an experienced provider. Since oxygenation is currently being maintained, the next step is not an immediate surgical airway but rather moving to a rescue airway strategy, such as inserting a supraglottic airway (SGA) like a King LT or LMA. This secures the airway less invasively while providing effective ventilation.

AEMCA - Advanced Emergency Medical Care Assistant Practice Test

AEMCA - Advanced Emergency Medical Care Assistant Practice Test

AEMCA - Advanced Emergency Medical Care Assistant Airway Management and Ventilation Questions and Answers