BCA Airway Management & Emergency Response 2

Question 1

A patient with a known difficult airway requires emergent intubation. The 'can't intubate, can't oxygenate' (CICO) scenario is declared. What is the immediate next step after failed oxygenation with a supraglottic airway?

Accepted Answer

Perform front-of-neck access (surgical airway)

Answer

In a CICO emergency, front-of-neck access (cricothyrotomy or surgical tracheotomy) is mandatory when oxygenation cannot be achieved by other means.

Question 2

When using video laryngoscopy with a hyperangulated blade, the anesthesiologist achieves an excellent glottic view but cannot advance the endotracheal tube. What is the most likely cause?

Accepted Answer

Acute angle between blade geometry and tracheal axis requires a stylet with matching curvature

Answer

Hyperangulated video laryngoscope blades create a sharp anterior angle requiring a pre-shaped stylet that matches the blade curve to navigate the tube into the trachea.

Question 3

During rapid sequence induction, succinylcholine 1.5 mg/kg is administered. How long should the anesthesiologist wait before intubating to ensure maximum fasciculation and relaxation?

Accepted Answer

45–60 seconds

Answer

Optimal intubating conditions after succinylcholine occur at approximately 45–60 seconds, coinciding with peak neuromuscular blockade.

Question 4

A patient develops subcutaneous emphysema and decreasing SpO2 shortly after endotracheal intubation. Breath sounds are absent on the left. The most likely diagnosis is:

Accepted Answer

Right main-stem bronchus intubation

Answer

Right main-stem intubation is the most common endobronchial intubation because the right bronchus has a less acute angle from the carina, resulting in absent left breath sounds.

Question 5

Which capnography waveform pattern is most consistent with a bronchospasm during mechanical ventilation?

Accepted Answer

Shark-fin (sloping plateau) waveform with elevated EtCO2

Answer

Bronchospasm causes prolonged expiration and uneven gas emptying, producing the characteristic shark-fin capnography waveform with elevated end-tidal CO2.

(BCA) Board of Certification in Anesthesiology Practice Test

(BCA) Board of Certification in Anesthesiology Practice Test

BCA Airway Management & Emergency Response 2