ECC Defibrillation & Airway Management 3 — Questions and Answers
Question 1: During endotracheal intubation confirmation, bilateral breath sounds are heard but the ETCO2 detector shows no color change after 6 breaths. What is the most likely cause?
- The tube is correctly placed but the detector is defective
- Esophageal intubation has occurred (Correct answer)
- Right mainstem bronchus intubation
- The patient has high CO2 levels
Correct answer: Esophageal intubation has occurred
Absence of CO2 on colorimetric capnography after 6 breaths strongly indicates esophageal intubation, which requires immediate tube removal and reintubation.
Question 2: What is the maximum recommended time for interrupting chest compressions to deliver ventilations with an advanced airway in place?
- No interruption needed; ventilate every 6 seconds asynchronously (Correct answer)
- 5-second pause per breath
- 10-second pause for 2 breaths
- 15-second pause for 2 breaths
Correct answer: No interruption needed; ventilate every 6 seconds asynchronously
Once an advanced airway is secured, ventilations should be delivered every 6 seconds (10/min) asynchronously without pausing chest compressions.
Question 3: Which rhythm is described as an organized, regular, narrow-complex rhythm WITHOUT a pulse?
- Ventricular fibrillation
- Pulseless electrical activity (PEA) (Correct answer)
- Asystole
- Ventricular tachycardia
Correct answer: Pulseless electrical activity (PEA)
PEA is characterized by an organized ECG rhythm with no detectable pulse, and it is treated with CPR and epinephrine rather than defibrillation.
Question 4: In a patient with a hairy chest, the best immediate action before placing AED pads is to:
- Place pads over the hair and increase energy
- Quickly shave or wipe the pad area to improve contact (Correct answer)
- Use pediatric pads instead
- Apply extra conductive gel over the pads
Correct answer: Quickly shave or wipe the pad area to improve contact
Chest hair can prevent adequate pad-skin contact, increasing impedance; rapid removal by shaving or using the first set of pads to wipe hair improves shock delivery.
Question 5: A laryngeal mask airway (LMA) is inserted and ventilation begins. Chest rise is absent despite proper technique. What is the FIRST corrective action?
- Remove the LMA and perform BVM ventilation (Correct answer)
- Reposition the patient's head and reattempt
- Inflate the cuff further
- Switch to a larger LMA size
Correct answer: Remove the LMA and perform BVM ventilation
If an LMA fails to provide adequate ventilation, it should be removed immediately and basic BVM ventilation resumed while preparing for another attempt.
Question 6: How should AED pads be positioned for an infant during cardiac arrest?
- Both pads on the anterior chest
- Anterior chest and posterior back (anterior-posterior) (Correct answer)
- Right sternal border and left apex
- Left and right lateral chest walls
Correct answer: Anterior chest and posterior back (anterior-posterior)
For infants, anterior-posterior pad placement is recommended because the small chest makes standard adult pad positioning impractical and risky.
Question 7: During two-rescuer CPR, the compressor and ventilator roles should be switched approximately every:
- 5 minutes
- 2 minutes (Correct answer)
- 10 minutes
- When the compressor becomes fatigued and asks
Correct answer: 2 minutes
Rescuers should switch compressor roles every 2 minutes (or 5 cycles of CPR) to prevent fatigue-related decline in compression quality.
ECC Defibrillation & Airway Management 3
During endotracheal intubation confirmation, bilateral breath sounds are heard but the ETCO2 detector shows no color change after 6 breaths.
What is the most likely cause?