Paramedics Exam Airway Management 2 — Questions and Answers
Question 1: A patient has a suspected cervical spine injury and requires airway management. Which technique is most appropriate for initial airway opening?
- Head-tilt chin-lift
- Jaw thrust maneuver (Correct answer)
- Nasopharyngeal airway insertion
- Cricothyrotomy
Correct answer: Jaw thrust maneuver
The jaw thrust maneuver opens the airway without extending the cervical spine, making it the preferred technique when spinal injury is suspected.
Question 2: When performing endotracheal intubation, the cuff should be inflated to what pressure range?
- 5-10 cmH2O
- 15-20 cmH2O
- 20-30 cmH2O (Correct answer)
- 35-45 cmH2O
Correct answer: 20-30 cmH2O
ETT cuff pressure of 20-30 cmH2O seals the airway without compromising tracheal mucosal perfusion.
Question 3: Which waveform on capnography indicates correct endotracheal tube placement?
- Flat waveform at 0 mmHg
- Square waveform with EtCO2 35-45 mmHg (Correct answer)
- Saw-tooth waveform
- Spike-only waveform
Correct answer: Square waveform with EtCO2 35-45 mmHg
A square capnography waveform with EtCO2 between 35-45 mmHg confirms tracheal placement with normal ventilation.
Question 4: A patient develops stridor after a bee sting and has increasing respiratory distress. What is the FIRST priority airway intervention?
- Nasopharyngeal airway
- Bag-valve-mask ventilation
- Early endotracheal intubation before swelling worsens (Correct answer)
- Immediate cricothyrotomy
Correct answer: Early endotracheal intubation before swelling worsens
Anaphylaxis-induced angioedema progresses rapidly; early intubation is critical before swelling makes the procedure impossible.
Question 5: What does a colorimetric CO2 detector turning YELLOW indicate after endotracheal intubation?
- Esophageal intubation confirmed
- Tracheal intubation confirmed (Correct answer)
- Device malfunction
- Low EtCO2
Correct answer: Tracheal intubation confirmed
Yellow color on a colorimetric detector indicates the presence of CO2, confirming tracheal (not esophageal) placement.
Question 6: Which of the following is a contraindication to nasotracheal intubation?
- Trismus
- Suspected basilar skull fracture (Correct answer)
- Gag reflex present
- Intact dentition
Correct answer: Suspected basilar skull fracture
Suspected basilar skull fracture is a contraindication because a nasotracheal tube could be inadvertently placed intracranially.
Question 7: After intubating a cardiac arrest patient, you note breath sounds only on the right side. What is the most likely cause?
- Pneumothorax
- Right mainstem bronchus intubation (Correct answer)
- Esophageal intubation
- Pulmonary edema
Correct answer: Right mainstem bronchus intubation
Unilateral breath sounds after intubation most commonly indicate right mainstem bronchus intubation due to the anatomy of the carina.
A patient has a suspected cervical spine injury and requires airway management.
Which technique is most appropriate for initial airway opening?