Advanced Airway Management & Ventilation Flashcards
7 cards from real CEP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Advanced Airway Management & Ventilation flashcards as text
A patient in respiratory failure has a SpO2 of 82% despite high-flow oxygen via NRB mask. You attempt RSI but cannot visualize the cords. What is the MOST appropriate next step?
Answer: Insert a supraglottic airway device
When intubation fails and oxygenation is inadequate, a supraglottic airway (LMA, King LT, i-gel) is the recommended rescue device before proceeding to a surgical airway.
Which waveform capnography finding is MOST consistent with severe bronchospasm?
Answer: Shark-fin waveform with elevated plateau
A shark-fin (sloped plateau) capnography waveform indicates obstructive airway disease such as severe bronchospasm or COPD exacerbation.
During BVM ventilation of an apneic adult, you notice the abdomen rising with each ventilation. What is the MOST likely cause?
Answer: Gastric inflation from excessive pressure
Abdominal rise during BVM ventilation indicates gastric insufflation caused by excessive ventilation pressure or volume exceeding the lower esophageal sphincter threshold.
A 45-year-old male requires RSI. His BMI is 42. Which positioning strategy BEST optimizes laryngoscopy conditions?
Answer: Ramped position with ear aligned to sternal notch
The ramped or 'sniffing' position with the external auditory meatus level with the sternal notch improves laryngoscopic view in obese patients by aligning oral, pharyngeal, and laryngeal axes.
After RSI with succinylcholine and etomidate, you confirm ET tube placement via waveform capnography. The ETCO2 is 12 mmHg. What should you suspect?
Answer: Pulmonary embolism or severely reduced cardiac output
A very low ETCO2 (under 15 mmHg) with confirmed tube placement suggests severe reduction in pulmonary blood flow, as seen in pulmonary embolism or low cardiac output states.
Which medication used in RSI is CONTRAINDICATED in a patient with a crush injury and suspected hyperkalemia?
Answer: Succinylcholine
Succinylcholine causes potassium efflux from muscle cells and is contraindicated in hyperkalemia, crush injuries, burns >24 hours, denervation injuries, and prolonged immobilization.
A ventilated patient develops acute hypotension, absent breath sounds on the left, and tracheal deviation to the right. The FIRST intervention should be:
Answer: Perform needle decompression on the left side
Absent breath sounds, tracheal deviation away from the affected side, and hypotension in a ventilated patient indicate tension pneumothorax requiring immediate needle decompression.