Advanced Airway Management Flashcards

During a flight transport, a patient's endotracheal tube cuff pressure should be maintained at what range to prevent tracheal mucosal ischemia?

Answer: 20-30 cmH2O

ETT cuff pressure should be maintained between 20-30 cmH2O to prevent mucosal ischemia while maintaining an adequate seal.

A CFRN is transporting a patient with a known difficult airway. The video laryngoscope fails. Which device is the most appropriate next step for a 'can't intubate, can't oxygenate' scenario?

Answer: Surgical cricothyrotomy

Surgical cricothyrotomy is the definitive rescue airway in a true 'can't intubate, can't oxygenate' situation when all other methods have failed.

At altitude, nitrogen-filled ETT cuffs may over-inflate due to gas expansion. What is the preferred filling agent during flight?

Answer: Normal saline or sterile water

Normal saline or sterile water is preferred to fill ETT cuffs during flight because liquids are incompressible and do not expand with altitude changes.

Which finding during waveform capnography indicates esophageal intubation?

Answer: Absence of CO2 waveform after intubation

Absence of a CO2 waveform after intubation is the most reliable indicator of esophageal placement, as the esophagus does not produce CO2.

A CFRN is managing a pediatric patient requiring intubation. Which formula correctly estimates uncuffed ETT size for a child?

Answer: (Age / 4) + 4

The formula (Age/4) + 4 estimates uncuffed ETT internal diameter in millimeters for pediatric patients.

During a rotor-wing transport, a mechanically ventilated patient develops sudden loss of breath sounds on the left with tracheal deviation to the right. The CFRN should first suspect:

Answer: Left tension pneumothorax

Absent left breath sounds with tracheal deviation to the right in a ventilated patient is classic for left tension pneumothorax requiring immediate needle decompression.

When performing rapid sequence intubation, succinylcholine is contraindicated in which patient population due to risk of fatal hyperkalemia?

Answer: Patients with burns older than 24-72 hours or crush injuries

Succinylcholine causes hyperkalemia via upregulated acetylcholine receptors in burn injuries older than 24-72 hours, crush injuries, and denervation injuries.