CEP Advanced Airway Management & Ventilation 4

Question 1

A patient is intubated with an 8.0 mm ETT. The cuff pressure is measured at 35 cmH2O. What is the clinical concern?

Accepted Answer

Excessive cuff pressure may cause tracheal ischemia and necrosis

Answer

Cuff pressures above 30 cmH2O can compromise tracheal mucosal perfusion, leading to ischemia, ulceration, and tracheal stenosis with prolonged inflation.

Question 2

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?

Accepted Answer

Masseter muscle rigidity suggesting malignant hyperthermia

Answer

Masseter muscle rigidity after succinylcholine administration is an early warning sign of malignant hyperthermia, a rare but life-threatening pharmacogenetic reaction.

Question 3

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?

Accepted Answer

Start at lower CPAP pressure (5 cmH2O) and coach the patient through it

Answer

Starting at lower CPAP pressure and providing coaching and reassurance increases patient tolerance and compliance, which is essential for CPAP to be effective.

Question 4

Which of the following best describes the mechanism of action of high-flow nasal cannula (HFNC) in improving oxygenation?

Accepted Answer

It washes out nasopharyngeal dead space and provides modest CPAP effect

Answer

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).

Question 5

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?

Accepted Answer

Tube displacement or esophageal intubation

Answer

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.

(CEP) Certified Emergency Paramedic Practice Test

(CEP) Certified Emergency Paramedic Practice Test

CEP Advanced Airway Management & Ventilation 4