AEMCA Airway Management and Ventilation 5 — Questions and Answers
Question 1: Which of the following BEST describes the purpose of cricoid pressure (Sellick maneuver) during intubation?
- To open the vocal cords for better visualization
- To compress the esophagus and reduce risk of passive regurgitation (Correct answer)
- To stabilize the trachea during tube insertion
- To increase oxygen saturation before intubation
Correct answer: To compress the esophagus and reduce risk of passive regurgitation
Cricoid pressure compresses the esophagus against the vertebral body, reducing the risk of passive gastric regurgitation during intubation.
Question 2: What is the correct ventilation rate for an adult patient who has a pulse but is apneic?
- 8–10 breaths per minute
- 10–12 breaths per minute (Correct answer)
- 16–20 breaths per minute
- 20–24 breaths per minute
Correct answer: 10–12 breaths per minute
Current guidelines recommend 10–12 breaths per minute (one breath every 5–6 seconds) for an adult with a pulse but no respirations.
Question 3: A patient's skin color, mental status, and SpO2 are all worsening despite BVM ventilations through an LMA. What should the AEMCA suspect?
- The LMA cuff has been over-inflated
- Improper LMA placement or inadequate seal (Correct answer)
- The patient needs a faster ventilation rate only
- Oxygen tank is nearly empty
Correct answer: Improper LMA placement or inadequate seal
Worsening despite LMA ventilation most commonly results from malposition or inadequate seal, requiring repositioning or a more definitive airway.
Question 4: When selecting an OPA size, the correct method is to measure from the:
- Center of the mouth to the earlobe
- Corner of the mouth to the earlobe (Correct answer)
- Tip of the nose to the earlobe
- Incisors to the angle of the jaw
Correct answer: Corner of the mouth to the earlobe
OPA size is estimated by measuring from the corner of the mouth to the earlobe (or center of mouth to angle of jaw).
Question 5: A trauma patient has a SpO2 of 88% on 15 L/min non-rebreather mask. Breath sounds are absent on the left. The MOST likely diagnosis is:
- Left mainstem bronchus intubation
- Left tension pneumothorax (Correct answer)
- Hemothorax requiring fluid resuscitation
- Pulmonary contusion requiring CPAP
Correct answer: Left tension pneumothorax
Absent unilateral breath sounds with hypoxia despite high-flow oxygen in a trauma patient strongly suggests tension pneumothorax requiring needle decompression.
Question 6: Which of the following is a sign of adequate ventilation during CPR without an advanced airway?
- SpO2 reading of 95% or higher
- Visible bilateral chest rise with each delivered breath (Correct answer)
- No gastric distension after 10 ventilations
- ETCO2 greater than 10 mmHg
Correct answer: Visible bilateral chest rise with each delivered breath
Visible bilateral chest rise with each ventilation is the primary clinical confirmation that ventilations are effective during CPR.
Question 7: A 3-year-old child presents in respiratory arrest. Which BVM mask size and ventilation rate are most appropriate?
- Infant mask, 10–12 breaths per minute
- Pediatric mask, 20–30 breaths per minute (Correct answer)
- Adult mask, 12–15 breaths per minute
- Infant mask, 30–40 breaths per minute
Correct answer: Pediatric mask, 20–30 breaths per minute
A pediatric mask sized to fit the child's face is used, and the recommended ventilation rate for children in arrest is 20–30 breaths per minute.
AEMCA Airway Management and Ventilation 5
Which of the following BEST describes the purpose of cricoid pressure (Sellick maneuver) during intubation?