AIRWAY 4

Question 1

After inserting the needle into through the cricothyroid membrane, you should next:

A: change your angle to 90° and advance the catheter over the needle.
B: aspirate with the syringe and then insert the needle about 2 cm farther.
C: insert the needle about 1 cm farther and then aspirate with the syringe.
D: advance the catheter over the needle until the hub is flush with the skin.

Answer 1

C: insert the needle about 1 cm farther and then aspirate with the syringe.

Question 2

Compared with an open cricothyrotomy, needle cricothyrotomy:

A: allows for subsequent attempts to intubate the patient.
B: requires the paramedic to manipulate the patient’s cervical spine.
C: is technically more difficult and takes longer to perform.
D: is associated with a higher risk of damage to adjacent structures.

Answer 2

A: allows for subsequent attempts to intubate the patient.

Question 3

During ventilation with the LMA, the paramedic should:

A: observe the patient for signs of inadequate ventilation.
B: maintain the patient’s head in a slightly flexed position.
C: suction the patient’s oropharynx at least every 2 minutes.
D: hyperventilate the patient to maximize tidal volume delivery.

Answer 3

A: observe the patient for signs of inadequate ventilation.

Question 4

How does the i-gel differ from the LMA?

A: The i-gel has a noninflatable mask.
B: The i-gel comes in only two sizes.
C: The i-gel mask holds more air than the LMA.
D: The lumen of the i-gel is smaller than the LMA.

Answer 4

A: The i-gel has a noninflatable mask.

Question 5

If ventilation is difficult after inserting a King LT airway, you should:

A: deflate both of the cuffs, withdraw the device 2 cm, and reattempt ventilation.
B: remove the King LT and immediately resume ventilation with a bag-mask device.
C: attach a manually triggered ventilator and observe for adequate chest rise.
D: gently withdraw the device, without deflating the cuffs, until ventilation is easier.

Answer 5

D: gently withdraw the device, without deflating the cuffs, until ventilation is easier.

Question 6

In contrast to a needle cricothyrotomy, an open cricothyrotomy:

A: involves the use of a high-pressure jet ventilator.
B: enables the paramedic to provide greater tidal volume.
C: is the preferred technique in patients with short, fat necks.
D: is easier to perform in children younger than 8 years of age.

Answer 6

B: enables the paramedic to provide greater tidal volume.

Question 7

In general, a multilumen airway should not be used in patients who are:

A: greater than 6 feet tall.
B: younger than 16 years of age.
C: older than 65 years of age.
D: less than 4 feet 5 inches tall.

Answer 7

B: younger than 16 years of age.

Question 8

Multilumen airways are contraindicated in patients with:

A: esophageal cancer.
B: cervical spine trauma.
C: traumatic cardiac arrest.
D: a history of gastric ulcers.

Answer 8

A: esophageal cancer.

Question 9

Needle cricothyrotomy is contraindicated in patients with:

A: uncontrolled oropharyngeal bleeding.
B: obstruction above the catheter insertion site.
C: massive maxillofacial trauma and trismus.
D: a suspected injury to the cervical spine.

Answer 9

B: obstruction above the catheter insertion site.

Question 10

Open cricothyrotomy is indicated when:

A: ET intubation is unsuccessful after three attempts.
B: all other methods of advanced airway management have failed.
C: you are unable to secure a patent airway with less invasive means.
D: the patient has a head injury that precludes nasotracheal intubation.

Answer 10

B: all other methods of advanced airway management have failed.

Question 11

Proper insertion of the LMA involves:

A: inserting the LMA into the patient’s mouth by following the curvature of the patient’s tongue.
B: lifting the patient’s jaw upward and blindly inserting the LMA until you meet resistance.
C: flexing the patient’s neck, depressing the tongue with a tongue blade, and blindly inserting the LMA.
D: inserting the LMA along the roof of the mouth and using your finger to push the airway against the hard palate.

Answer 11

D: inserting the LMA along the roof of the mouth and using your finger to push the airway against the hard palate.

Question 12

Proper placement of the King LT airway is performed by all of the following techniques, EXCEPT:

A: auscultation of bilateral breath sounds.
B: the esophageal detector device.
C: quantitative waveform capnography.
D: observation for symmetrical chest rise.

Answer 12

B: the esophageal detector device.

Question 13

The cricothyroid membrane is the ideal site for making a surgical opening into the trachea because:

A: no important structures lie between the skin covering the cricothyroid membrane and the airway.
B: the tough cartilage that comprises the cricothyroid membrane can easily be incised with a scalpel.
C: there are no major blood vessels or other structures that lie adjacent to the cricothyroid membrane.
D: the cricoid cartilage helps prevent accidental perforation through the back of the airway and into the esophagus.

Answer 13

A: no important structures lie between the skin covering the cricothyroid membrane and the airway.

Question 14

The external jugular veins run ____________ and are located ____________ to the cricothyroid membrane.

A: vertically, lateral
B: vertically, medial
C: horizontally, lateral
D: horizontally, medial

Answer 14

A: vertically, lateral

Question 15

The King airway should NOT be used in patients:

A: with known esophageal disease.
B: with prolonged cardiac arrest.
C: with a traumatic brain injury.
D: who weigh less than 25 kg.

Answer 15

A: with known esophageal disease.

Question 16

The King LT airway can be used to:

A: administer certain cardiac medications directly into the trachea.
B: maintain a patent airway in spontaneously breathing patients.
C: establish a patent airway in patients of any age and body size.
D: suction pulmonary secretions from the tracheobronchial tree.

Answer 16

B: maintain a patent airway in spontaneously breathing patients.

Question 17

The King LT-D airway features a:

A: straight tube with two inflatable cuffs that hold an equal amount of air.
B: port through which gastric contents can be suctioned from the stomach.
C: curved tube with ventilation ports located between two inflatable cuffs.
D: universal size with two inflation ports and is used for patients of any age.

Answer 17

C: curved tube with ventilation ports located between two inflatable cuffs.

Question 18

The LMA is:

A: a suitable airway device for use in morbidly obese patients.
B: an alternative to bag-mask ventilation when intubation is not possible.
C: associated with a higher risk of damage to the vocal cords than intubation.
D: especially effective for CHF patients who require high pulmonary pressures

Answer 18

B: an alternative to bag-mask ventilation when intubation is not possible.

Question 19

The main disadvantage of the LMA is that it:

A: does not provide protection against aspiration.
B: spontaneously dislodges in the majority of patients.
C: is associated with significant upper airway swelling.
D: is technically more difficult to perform than intubation.

Answer 19

A: does not provide protection against aspiration.

Question 20

The major advantage of the multilumen airway is that:

A: it can be used in children and adults as an alternative airway device.
B: no mask seal is required to ventilate with either of the multilumen airways.
C: intubating the trachea with the multilumen airway in place is extremely easy.
D: effective ventilation is possible if the tube enters the esophagus or the trachea.

Answer 20

D: effective ventilation is possible if the tube enters the esophagus or the trachea.

Question 21

The MOST significant complication associated with the use of multilumen airways is:

A: laryngospasm or vomiting during insertion of the tube.
B: unrecognized displacement of the tube into the esophagus.
C: vocal cord damage if the tube inadvertently enters the trachea.
D: pharyngeal or esophageal trauma secondary to poor technique.

Answer 21

B: unrecognized displacement of the tube into the esophagus.

Question 22

When checking the cuff of the LMA prior to insertion, you should:

A: stretch the cuff to check for tears or other damage.
B: inflate the cuff with 100 mL of air and then deflate.
C: gently pull on the cuff at the tube to ensure integrity.
D: inflate the cuff with 50% more air than is required.

Answer 22

D: inflate the cuff with 50% more air than is required.

Question 23

When performing an open cricothyrotomy, you should FIRST:

A: maintain aseptic technique as you cleanse the area with iodine.
B: slide your index finger between the thyroid and cricoid cartilages.
C: palpate for the V notch of the thyroid cartilage and stabilize the larynx.
D: hyperextend the patient’s neck and then palpate the cricoid cartilage.

Answer 23

C: palpate for the V notch of the thyroid cartilage and stabilize the larynx.

Question 24

When performing an open cricothyrotomy, you will MOST likely avoid damage to the jugular veins if:

A: the patient’s head is hyperextended.
B: you incise the cricothyroid membrane at a transverse angle.
C: the patient’s head is in a neutral position.
D: the cricothyroid membrane is incised vertically.

Answer 24

D: the cricothyroid membrane is incised vertically.

Question 25

You should be MOST suspicious of tube misplacement following an open cricothyrotomy if:

A: bleeding from the subcutaneous tissues is observed.
B: there is minimal rise of the chest during ventilations.
C: progressive redness is noted around the insertion site.
D: a crackling sensation is noted when palpating the neck

Answer 25

D: a crackling sensation is noted when palpating the neck