Airway and Ventilation Management Flashcards

A trauma patient with facial burns and singed nasal hairs has a hoarse voice. The priority intervention is:

Answer: Early endotracheal intubation before airway edema progresses

Hoarseness with facial burns and singed nasal hairs indicates impending airway compromise from edema. Early intubation is critical before swelling makes it impossible.

Which airway adjunct is most appropriate as a temporizing measure for an unconscious trauma patient with intact gag reflex?

Answer: Nasopharyngeal airway (NPA)

A nasopharyngeal airway is better tolerated in patients with an intact gag reflex compared to an oropharyngeal airway, which would stimulate gagging and vomiting.

During rapid sequence intubation of a trauma patient, cricoid pressure (Sellick maneuver) is applied primarily to:

Answer: Prevent aspiration by occluding the esophagus

Cricoid pressure compresses the esophagus against the cervical vertebral body, reducing the risk of passive regurgitation and aspiration during intubation.

A trauma patient has oxygen saturation of 85% despite bag-valve-mask ventilation with 100% oxygen. Breath sounds are absent on the left with tracheal deviation to the right. The immediate intervention is:

Answer: Needle decompression at the left 2nd intercostal space, midclavicular line

Absent breath sounds, tracheal deviation away from the affected side, and hypoxemia indicate tension pneumothorax requiring immediate needle decompression.

Which of the following confirms correct endotracheal tube placement most reliably?

Answer: Continuous waveform capnography (ETCO2)

Continuous waveform capnography providing end-tidal CO2 detection is the gold standard for confirming and continuously monitoring correct endotracheal tube placement.

A trauma patient requires a surgical airway. The anatomical landmark for cricothyrotomy is the membrane between the:

Answer: Thyroid cartilage and cricoid cartilage

An emergency cricothyrotomy is performed through the cricothyroid membrane, located between the inferior border of the thyroid cartilage and the superior border of the cricoid cartilage.

What is the primary risk of hyperventilating a patient with traumatic brain injury?

Answer: Cerebral vasoconstriction leading to secondary brain ischemia

Hyperventilation causes hypocapnia, which leads to cerebral vasoconstriction, reducing cerebral blood flow and potentially worsening secondary brain injury.

A patient with a tracheostomy from a previous surgery presents with trauma and respiratory distress. The first step in airway management is:

Answer: Suction the tracheostomy tube and assess patency

Suctioning and assessing patency of the existing tracheostomy tube is the first step, as obstruction by blood, secretions, or a mucus plug is the most common cause of respiratory distress in tracheostomy patients.

In a patient with suspected cervical spine injury requiring intubation, which technique best minimizes cervical spine movement?

Answer: Video laryngoscopy with manual in-line stabilization

Video laryngoscopy combined with manual in-line stabilization provides the best visualization while minimizing cervical spine movement compared to direct laryngoscopy.

Which sign indicates complete airway obstruction in a conscious trauma patient?

Answer: Inability to speak, cough, or breathe with universal choking sign

Complete airway obstruction presents with inability to speak, cough, or breathe. The universal choking sign (hands clutching the throat) is characteristic. Any vocalization indicates partial, not complete, obstruction.

When managing a patient with a flail chest segment, which ventilation strategy is most appropriate?

Answer: Positive pressure ventilation if respiratory failure develops

Positive pressure ventilation provides internal pneumatic stabilization of the flail segment when respiratory failure develops. Adequate pain control is essential for non-intubated patients.

A trauma patient presents with subcutaneous emphysema of the neck and upper chest. This finding most likely indicates:

Answer: Pneumothorax, tracheal injury, or esophageal rupture

Subcutaneous emphysema in the neck and upper chest indicates air leaking into soft tissues, most commonly from pneumothorax, tracheobronchial injury, or less commonly esophageal perforation.