AEMCA Airway Management and Ventilation 3 — Questions and Answers
Question 1: Waveform capnography shows a sudden drop in ETCO2 to near zero during CPR. What is the MOST likely cause?
- Return of spontaneous circulation
- Esophageal intubation (Correct answer)
- Hyperventilation
- Pulmonary embolism
Correct answer: Esophageal intubation
A sudden drop in ETCO2 to near zero during CPR strongly suggests esophageal intubation, as the esophagus does not produce CO2.
Question 2: A patient with severe anaphylaxis develops stridor and a hoarse voice. What airway complication is most likely developing?
- Bronchospasm
- Upper airway edema and impending obstruction (Correct answer)
- Tension pneumothorax
- Pulmonary edema
Correct answer: Upper airway edema and impending obstruction
Stridor and hoarseness in anaphylaxis indicate angioedema of the upper airway with progressive obstruction requiring immediate intervention.
Question 3: What is the appropriate tidal volume to deliver when ventilating an adult with a BVM?
- 250–300 mL
- 500–600 mL (Correct answer)
- 800–1000 mL
- 1200–1500 mL
Correct answer: 500–600 mL
Current guidelines recommend 500–600 mL tidal volume (visible chest rise) to avoid gastric inflation and barotrauma.
Question 4: Which landmark is used to confirm proper endotracheal tube depth in an average adult male?
- Tube tip at 18 cm at the teeth
- 22 cm mark at the lip for males (Correct answer)
- Cuff should be at vocal cord level
- 25 cm mark at the lips for all adults
Correct answer: 22 cm mark at the lip for males
For average adult males, the ETT is positioned at approximately 22–23 cm at the lip to place the tube tip mid-trachea.
Question 5: A supraglottic airway device (e.g., King LT or LMA) is best described as:
- A definitive airway that protects against aspiration completely
- An alternative airway that sits above or around the glottis (Correct answer)
- A device only used for apneic patients
- A device that requires direct laryngoscopy to insert
Correct answer: An alternative airway that sits above or around the glottis
Supraglottic airways are inserted without visualizing the glottis and provide ventilation but do not fully protect against aspiration like an ETT.
Question 6: When ventilating a patient with a suspected tension pneumothorax, which ventilation change would WORSEN the condition?
- Decreasing respiratory rate
- Increasing tidal volume and rate (overventilation) (Correct answer)
- Reducing inspiratory time
- Using a PEEP valve
Correct answer: Increasing tidal volume and rate (overventilation)
Overventilation increases intrathoracic pressure, which worsens tension pneumothorax by further compressing mediastinal structures.
Question 7: The AEMCA is ventilating a pediatric patient. How should BVM ventilation differ from adult technique?
- Use faster rates and larger tidal volumes
- Use age-appropriate mask size, lower tidal volumes, and faster rates (Correct answer)
- Use the same technique but with a smaller mask
- Squeeze the bag harder to overcome pediatric airway resistance
Correct answer: Use age-appropriate mask size, lower tidal volumes, and faster rates
Pediatric patients require age-appropriate equipment, smaller tidal volumes (visible chest rise), and faster ventilation rates than adults.
AEMCA Airway Management and Ventilation 3
Waveform capnography shows a sudden drop in ETCO2 to near zero during CPR.
What is the MOST likely cause?