Airway Management & Intubation Flashcards

Cricothyrotomy is indicated in which situation?

Answer: Can't intubate, can't oxygenate (CICO) — failed airway with life-threatening hypoxia

Cricothyrotomy (surgical or needle) is a rescue intervention reserved for the CICO scenario — when all other airway methods have failed and the patient is dying of hypoxia — providing direct tracheal access below the obstruction.

The cricothyroid membrane is located:

Answer: Between the thyroid cartilage superiorly and the cricoid cartilage inferiorly

The cricothyroid membrane is palpable between the thyroid cartilage (Adam's apple) superiorly and the cricoid cartilage (ring) inferiorly — the landmark for emergency surgical airway access.

Post-intubation sedation and analgesia in the pre-hospital setting is important because:

Answer: Paralysis from RSI wears off and an awake, intubated patient will fight the tube and hyperventilate

Neuromuscular blockade from succinylcholine wears off in 8-10 minutes; ongoing sedation and analgesia prevent patient awareness, fighting against the tube, self-extubation, and dangerous sympathetic responses.

An end-tidal CO2 reading of 20 mmHg in a breathing, non-arrested patient after intubation suggests:

Answer: Oesophageal intubation (or extreme hyperventilation) — verify tube position immediately

A very low ETCO2 of 20 mmHg in a breathing patient most likely indicates oesophageal intubation (where CO2 from a few gastric CO2 washes out rapidly) and must be immediately evaluated with laryngoscopy.

The nasopharyngeal airway (NPA) is preferred over the oropharyngeal airway (OPA) in which situation?

Answer: Semi-conscious patients with intact gag reflex, or patients with jaw clenching (trismus)

The NPA is better tolerated in patients with some level of consciousness and an intact gag reflex; it does not trigger the gag response as readily as an OPA and can be used when mouth opening is restricted.

Bougie-assisted intubation is used when:

Answer: Partial (limited) glottic view makes direct tube passage difficult — the bougie confirms tracheal entry via tactile feedback

The bougie (endotracheal tube introducer) is passed through a limited glottic view; tracheal rings provide a 'clicks' tactile sensation, and the bougie stops as it wedges in the bronchus — both confirming tracheal placement before railroading the ETT.