DCAS Airway Management & Intubation 2

Question 1

Sellick's manoeuvre (cricoid pressure) in RSI is designed to:

Accepted Answer

Compress the oesophagus against the vertebral body to reduce regurgitation risk during intubation

Answer

Cricoid pressure compresses the oesophagus between the cricoid ring and vertebral body, theoretically preventing passive regurgitation of gastric contents during induction; its routine use is now controversial as it may worsen laryngoscopic view.

Question 2

Succinylcholine (suxamethonium) as an RSI agent is contraindicated in:

Accepted Answer

Hyperkalaemia, crush injuries, burns >24 hours old, and known or suspected pseudocholinesterase deficiency

Answer

Succinylcholine causes potassium release (∼0.5mEq/L normally); in hyperkalaemic states, or conditions with upregulated acetylcholine receptors (burns, crush, denervation), this can cause fatal cardiac arrest.

Question 3

The correct depth of insertion for a nasopharyngeal airway (NPA) approximates:

Accepted Answer

Distance from the tip of the nose to the earlobe (7-9cm in most adults)

Answer

The NPA is sized by measuring from the nostril to the tragus of the ear (approximately 7-9cm in adults), ensuring the tube reaches the posterior pharynx without entering the larynx or oesophagus.

Question 4

During RSI, the typical induction dose of ketamine for a haemodynamically compromised patient is:

Accepted Answer

1-2mg/kg IV (reduced dose for haemodynamic compromise vs 1-2mg/kg standard)

Answer

Ketamine 1-2mg/kg IV provides dissociative anaesthesia with haemodynamic preservation (sympathomimetic properties) — doses at the lower end are used in haemodynamically compromised patients to avoid catecholamine depletion.

Question 5

A 'difficult airway' algorithm should include which rescue device if intubation fails?

Accepted Answer

Supraglottic airway (SGA) such as laryngeal mask airway (LMA) or i-gel as a bridge to oxygenation

Answer

Failed intubation should trigger a 'can't intubate, can ventilate' response using an SGA as a rescue device for oxygenation; cricothyrotomy is reserved for 'can't intubate, can't oxygenate' (CICO) scenarios.

DCAS Practice Test

DCAS Practice Test

DCAS Airway Management & Intubation 2