ATLS Airway and Ventilatory Management 2

Question 1

A trauma patient presents with a GCS of 7, copious oral bleeding, and suspected cervical spine injury. What is the most appropriate airway management approach?

Accepted Answer

Rapid sequence intubation with in-line cervical stabilization

Answer

Nasotracheal intubation

Answer

Surgical cricothyroidotomy

Answer

Bag-valve-mask ventilation until CT clears the spine

Question 2

Which clinical sign most reliably indicates tension pneumothorax requiring immediate intervention?

Accepted Answer

Unilateral absent breath sounds with hypotension and tracheal deviation

Answer

Subcutaneous emphysema

Answer

Oxygen saturation below 90%

Answer

Paradoxical chest wall movement

Question 3

What is the primary indication for performing a surgical cricothyroidotomy in trauma?

Accepted Answer

Failed orotracheal intubation with inability to ventilate

Answer

Patient refusal of orotracheal intubation

Answer

Suspected cervical spine fracture

Answer

Bilateral rib fractures with flail chest

Question 4

During the primary survey, a patient has oxygen saturation of 85% despite high-flow oxygen. Breath sounds are present bilaterally. What should be evaluated next?

Accepted Answer

Check for flail chest or pulmonary contusion

Answer

Order a CT angiogram for pulmonary embolism

Answer

Perform bilateral chest tube insertion

Answer

Begin continuous positive airway pressure

Question 5

Which of the following patients would be most appropriate for needle cricothyroidotomy rather than surgical cricothyroidotomy?

Accepted Answer

An 8-year-old with a failed intubation attempt

Answer

A 45-year-old with massive facial trauma

Answer

A 30-year-old with laryngeal fracture

Answer

A 60-year-old with known tracheal stenosis

Question 6

A trauma patient develops progressive hoarseness, stridor, and subcutaneous emphysema in the neck. Which injury should be most strongly suspected?

Accepted Answer

Laryngeal fracture

Answer

Esophageal perforation

Answer

Tension pneumothorax

Answer

Carotid artery dissection