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 is intubated with an 8.0 mm ETT. The cuff pressure is measured at 35 cmH2O. What is the clinical concern?
Answer: Excessive cuff pressure may cause tracheal ischemia and necrosis
Cuff pressures above 30 cmH2O can compromise tracheal mucosal perfusion, leading to ischemia, ulceration, and tracheal stenosis with prolonged inflation.
During RSI, you administer succinylcholine. After 60 seconds, you attempt laryngoscopy and find the jaw is rigid and the mouth cannot be opened. What is the MOST likely cause?
Answer: Masseter muscle rigidity suggesting malignant hyperthermia
Masseter muscle rigidity after succinylcholine administration is an early warning sign of malignant hyperthermia, a rare but life-threatening pharmacogenetic reaction.
A CPAP mask is being applied to a patient with acute pulmonary edema. The patient reports claustrophobia and begins to remove the mask. What is the BEST initial response?
Answer: Start at lower CPAP pressure (5 cmH2O) and coach the patient through it
Starting at lower CPAP pressure and providing coaching and reassurance increases patient tolerance and compliance, which is essential for CPAP to be effective.
Which of the following best describes the mechanism of action of high-flow nasal cannula (HFNC) in improving oxygenation?
Answer: It washes out nasopharyngeal dead space and provides modest CPAP effect
HFNC improves oxygenation by flushing CO2 from nasopharyngeal dead space, providing a consistent FiO2, and generating a small amount of positive airway pressure (1-3 cmH2O).
An intubated patient's ETCO2 suddenly drops from 40 mmHg to 5 mmHg with no change in ventilator settings. What is the MOST critical diagnosis to rule out first?
Answer: Tube displacement or esophageal intubation
A sudden drop in ETCO2 to near-zero levels in an intubated patient must immediately prompt assessment for tube dislodgement or esophageal intubation before any other cause.
A 6-year-old requires emergent intubation. Using the length-based resuscitation tape (Broselow), the appropriate uncuffed ETT size is 5.0 mm. Which formula confirms this sizing?
Answer: (Age/4) + 4
The standard formula for uncuffed ETT size in pediatric patients is (age in years / 4) + 4, which for a 6-year-old gives (6/4) + 4 = 5.5, confirming approximate Broselow sizing.
During a difficult airway situation, you attempt to use a bougie (endotracheal tube introducer). Which tactile sensation confirms correct tracheal placement of the bougie?
Answer: A clicking or 'tracheal rings' sensation as it advances
Correct tracheal placement of the bougie is confirmed by the tracheal clicks felt as the tip contacts the tracheal rings (hold-up at ~26-30 cm in adults also confirms bronchus entry).