Advanced Airway

What does the “A” in the mnemonic MOANS stand for?
A. Apnea
B. Age
C. Airway
D. Amidate

A nasogastric or oro gastric tube should be inserted on all patients who have received bag valve mask ventilation and require continued mechanical ventilation.
a. True
b. False

A laryngeal mask airway (LMA) will prevent regurgitation and aspiration of gastric contents if it is placed correctly.
a. True
b. False

WhichofthefollowingstatementsregardingtheCombiTubeTMistrue?
A. Studies have shown that ventilation performance is equivalent to
B. 80% of the time the tube will be placed in the trachea
C. It must be placed under direct visualization
endotracheal intubation
d. Successful placement rates are very low (less than 50%)

The King LTT M airway is not designed to be used with high pressure ventilation (> 30 cmH20).
a. True
b. False

Which of the following patients would be a candidate for a bougie-assisted intubation?
A. A patient with a predicted grade 4 view of the glottis in which the intubator is unsure of the tracheal location
B. A patient with a suspected transection of the trachea
C. A patient witha grade 3 view of the glottis in which the intubator feels that there might be poor view of the trachea
D. A patient with a suspected trachea-esophageal fistula

You are passing a bougie into the trachea to facilitate intubation when you were unable to visualize the cords. Which of the following is true regarding the use of the bougie?
A. Proper placement of the bougie is confirmed when you see a “glow” emanating from the trachea
B. Proper placement of the bougie is confirmed when you are able to pass the endotracheal tube alongside the bougie
C. Proper placement of the bougie is confirmed when you feel a “clicking” sensation as the bougie contacts the tracheal rings
D. Proper placement of the bouge is confirmed when you feel the bougie bump the carina

With proper equipment, a needle cricothyrotomy achieves ventilation, but not oxygenation.
a. True
b. False

What does the “H” stand for int he SHORT mnemonic used for surgical airway contraindications?
A. Hypercapnia
B. Hematoma
C. Hypoxia
D. Hyperventilation

Your partner has just placed an esophageal detector device (EDD) on the endotracheal tube. The device slowly inflates. Which of the following is true?
A. Slow inflation indicates that the EDD is not properly working and should be replaced
B. Slow inflation only occurs if the patient was not adequately ventilated prior to use of the EDD
C. Slow inflation indicates correct placement of the endotracheal tube into the trachea
D. Slow inflation typically indicates placement of the endotracheal tube in the esophagus

Continuous waveform capnography will immediately detect accidental extubation or disconnection from the ventilator.
a. True
b. False

You suspect that your patient has methemoglobinemia. This will decrease the accuracy of pulse oximetry readings.
a. True
b. False

You are preparing to intubate a patient in the operating suite for annual skills check-offs. The anesthesiologist instructs you to perform a “nitrogen washout”. Which of the following best describes this procedure?
A. You will preoxygenate the patient to remove carbon dioxide
B. You will give the patient a fluid bolus of 1 liter of normal saline or Ringers lactate to washout nitrogen in their blood
C. You will begin to push etomidate slowly followed by succinylcholine
D. You will administration nitroglycer in to the patient as long as their SBP is > 100 mmHg

All patients should receive bag mask ventilation with 100% oxygen prior to attempting RSI.
a. True
b. False

You are preparing to intubate your patient and your partner tells you that he thinks that this patient will be a Grade IV on the Cormack-Lehane. Which of the following would be true regarding your partner’s statement?
A. A Grade IV Cormack-Lehane indicates that only a portion of the vocal cords can be viewed under direct laryngoscopy
B. A Grade IV Cormack-Lehane indicates a predicted easyi ntubation
C. There is no such thing as a Grade IV Cormack-Lehane. He has this confused with the Mallampati grading system
D. A Grade IV Cormack-Lehane indicates that no portion of the vocal cords can be viewed under direct laryngoscopy and this will be a very difficult intubation

What is the minimum number of vital capacity breaths your patient must take while on 100% oxygen in order to effectively preoxygenate prior to RSI?
A. 6
B. 8
C. 12
D. 10

Which of the following is a reason why lidocaine could be administered as a pretreatment drug before RSI?
A. To aid in drying increased secretions
B. Patients who are at risk for increased ICP
C. Children under the age of 8
D. Patients who are receiving etomidate

Which of the following is the correct dose for lidocaine as a pretreatment drug in RSI?
A. 0.3mg/kg
B. 1mg/kg
C. 1.5 mg/kg
D. 2mg/kg

You have been ordered by your medical control to administer a defasciculating dose of vecuronium. Which of the following is the correct adult dosage for this drug?
A. 0.01mg/kg
B. 1mg/kg
C. 0.001mg/kg
D. 0.1 mg/kg

What is the minimum number of vital capacity breaths your patient must take while on 100% oxygen in order to effectively preoxygenate prior to RSI?
A. 10
B. 6
C. 8
D. 12

Which of the following is a reason why lidocaine could be administered as a pretreatment drug before RSI?
A. Children under the age of 8
B. To aid in drying increased secretions
C. Patients who are receiving etomidate
D. Patients who are at risk for increased ICP

Which of the following is the correct dose for lidocaine as a pretreatment drug in RSI?
A. 0.3mg/kg
B. 1mg/kg
C. 1.5 mg/kg
D. 2mg/kg

You have been ordered by your medical control to administer a defasciculating dose of vecuronium. Which of the following is the correct adult dosage for this drug?
A. 1mg/kg
B. 0.01mg/kg
C. 0.001mg/kg
D. 0.1 mg/kg

Which of the following are considered the “gold standard” methods for confirming endotracheal tube placement?
A. Direct visualization of the tube passing through the cords and equal lung sounds
B. Direct visualization of the tube passing through the cords and continuous waveform capnography
C. Positive lung sounds and continuous wave form capnography
D. Positive lung sounds and misting in the endotracheal tube