Airway Management & Intubation Flashcards

The laryngeal mask airway (LMA) does NOT provide:

Answer: Protection against aspiration of gastric contents

The LMA sits in the hypopharynx above the larynx without cuffing the trachea, providing a patent airway and ventilation conduit but offering no protection against regurgitation and aspiration.

Adequate pre-oxygenation before RSI aims to achieve a SpO2 of:

Answer: 100% (or as close as possible) on high-flow oxygen for at least 3 minutes to maximise oxygen reserve

Pre-oxygenation denitrogenates the functional residual capacity, extending the apnoea time (safe apnoea period) before desaturation; achieving SpO2 100% maximises the oxygen reserve available during the intubation attempt.

Which induction agent used in RSI has the property of maintaining haemodynamic stability and providing bronchodilation?

Answer: Ketamine

Ketamine's sympathomimetic properties increase heart rate and blood pressure (via catecholamine release), providing haemodynamic stability in shock states; it also causes bronchodilation making it ideal for intubation of asthmatic patients.

The 'sniffing position' for intubation aligns:

Answer: The oral, pharyngeal, and laryngeal axes to provide the best laryngoscopic view

The sniffing position (neck flexed, head extended) aligns the oral-pharyngeal-laryngeal axis, improving the laryngoscopic view of the glottis; a folded towel under the occiput achieves this in most adults.

Following intubation of a trauma patient with suspected haemopneumothorax, SpO2 suddenly drops. The first action is:

Answer: Disconnect BVM and verify tube position — listen for bilateral breath sounds

Post-intubation desaturation has multiple causes (oesophageal intubation, right main bronchus, tension pneumothorax, haemothorax); systematically checking tube position first (DOPE: Displacement, Obstruction, Pneumothorax, Equipment failure) guides definitive management.

The King LT or i-gel supraglottic airway is considered a 'second-generation' SGA because it:

Answer: Incorporates a gastric drainage channel reducing aspiration risk compared to first-generation SGAs

Second-generation SGAs include a gastric drain channel through which a gastric tube can be passed to decompress the stomach and reduce regurgitation risk — an advantage over classic LMAs which lack this feature.