Advanced Airway Management Flashcards

During high-altitude transport, a mechanically ventilated patient's tidal volume delivered by a flow-triggered transport ventilator increases unexpectedly. What is the most likely cause?

Answer: Decreased ambient pressure causing the ventilator to deliver more volume to achieve set pressure

In pressure-controlled modes, lower ambient pressure at altitude means the ventilator delivers more volume to achieve the set driving pressure, potentially causing volutrauma.

A CFRN is caring for a patient with a suspected C-spine injury who needs emergent intubation. Which technique is MOST appropriate?

Answer: Video laryngoscopy with manual inline stabilization (MILS)

Video laryngoscopy with manual inline stabilization (MILS) provides improved glottic view with minimal cervical spine movement, balancing airway management with C-spine protection.

Which sign is the MOST reliable bedside indicator that a King LT or Combitube supraglottic airway is seated in the esophagus (correct position)?

Answer: Positive waveform capnography with each breath

Positive waveform capnography confirming CO2 with each breath is the most reliable indicator of ventilation through a correctly positioned supraglottic airway.

A CFRN is transporting a pediatric patient who was submerged in cold water. The patient is unconscious with no gag reflex. What is the FIRST priority?

Answer: Establish definitive airway control with RSI and orotracheal intubation

An unconscious drowning victim with no protective reflexes requires immediate definitive airway management to protect against aspiration and ensure adequate oxygenation.

When using a Macintosh laryngoscope blade, the tip of the blade is correctly positioned in which anatomical structure to elevate the epiglottis?

Answer: Vallecula (between base of tongue and epiglottis)

The Macintosh blade tip is placed in the vallecula; lifting the blade anteriorly creates tension on the hyoepiglottic ligament, indirectly elevating the epiglottis.

A flight patient post-RSI develops a 'shark fin' or upsloping waveform on capnography. This pattern is MOST consistent with:

Answer: Obstructive disease (bronchospasm or COPD exacerbation) causing incomplete exhalation

A 'shark fin' or upsloping capnography waveform reflects incomplete exhalation due to airflow obstruction, as seen in bronchospasm or COPD.

A CFRN is managing a patient with Ludwig's angina requiring airway intervention. Why is awake fiberoptic intubation (AFOI) preferred over RSI in this patient?

Answer: Paralysis from RSI may cause complete airway collapse in a patient whose airway is maintained by muscle tone

In Ludwig's angina, muscle tone and patient positioning may be maintaining a partially obstructed airway; paralysis can cause total airway collapse making ventilation and intubation impossible.