AEMCA Airway Management and Ventilation 4 — Questions and Answers
Question 1: A patient has gurgling respirations after a seizure. What is the FIRST intervention?
- Insert an oropharyngeal airway
- Suction the airway (Correct answer)
- Perform a jaw-thrust
- Begin BVM ventilations
Correct answer: Suction the airway
Gurgling indicates secretions or fluid in the upper airway; suctioning must occur immediately to clear the obstruction before other interventions.
Question 2: During suction of an intubated patient, how long should each suction pass last?
- Up to 30 seconds
- No more than 10–15 seconds (Correct answer)
- 5 seconds maximum
- As long as needed to clear secretions
Correct answer: No more than 10–15 seconds
Suction passes should be limited to 10–15 seconds to prevent hypoxia and atelectasis from removing oxygen along with secretions.
Question 3: A patient with COPD is found with a decreased level of consciousness and a SpO2 of 72%. The AEMCA should:
- Withhold oxygen to avoid suppressing the hypoxic drive
- Apply high-flow oxygen and be prepared to assist ventilations (Correct answer)
- Use a Venturi mask set at 24% FiO2 only
- Observe the patient without oxygen until SpO2 falls below 60%
Correct answer: Apply high-flow oxygen and be prepared to assist ventilations
Severe hypoxia (SpO2 72%) is immediately life-threatening; high-flow oxygen and ventilatory support take priority over concern about hypoxic drive.
Question 4: Which clinical sign BEST indicates that a patient's airway is partially obstructed by the tongue?
- Cyanosis of the lips
- Snoring respirations (Correct answer)
- Absent breath sounds bilaterally
- Paradoxical chest movement
Correct answer: Snoring respirations
Snoring respirations occur when the relaxed tongue partially occludes the posterior pharynx, a classic sign of soft-tissue upper airway obstruction.
Question 5: After inserting an oropharyngeal airway (OPA), the patient begins to gag and vomit. What should the AEMCA do immediately?
- Push the OPA deeper to secure it
- Remove the OPA and suction the airway (Correct answer)
- Apply chin-lift to keep the airway open with the OPA in place
- Rotate the OPA to a different position
Correct answer: Remove the OPA and suction the airway
If an OPA triggers gagging or vomiting, it must be removed immediately and the airway suctioned to prevent aspiration.
Question 6: When is a nasal cannula at 6 L/min appropriate?
- For a patient in severe respiratory distress needing maximum FiO2
- For a patient with mild hypoxia who is breathing adequately (Correct answer)
- For any patient requiring supplemental oxygen
- For a patient requiring controlled low-concentration oxygen
Correct answer: For a patient with mild hypoxia who is breathing adequately
Nasal cannula at 2–6 L/min is appropriate for patients with mild to moderate hypoxia who are breathing adequately on their own.
Question 7: A rise in ETCO2 from 20 mmHg to 35 mmHg during CPR most likely indicates:
- The patient is being hyperventilated
- Return of spontaneous circulation (ROSC) (Correct answer)
- Esophageal intubation
- Worsening metabolic acidosis
Correct answer: Return of spontaneous circulation (ROSC)
A sudden sustained rise in ETCO2 toward normal levels (35–45 mmHg) during CPR is a strong indicator of ROSC as cardiac output resumes.
AEMCA Airway Management and Ventilation 4
A patient has gurgling respirations after a seizure.
What is the FIRST intervention?