AMLS Airway Management 2 — Questions and Answers
Question 1: Which finding indicates right mainstem intubation after ETT placement?
- Absent breath sounds on the left with unilateral chest rise (Correct answer)
- Bilateral equal breath sounds
- Gastric gurgling over the epigastrium
- ETCO2 waveform present
Correct answer: Absent breath sounds on the left with unilateral chest rise
Right mainstem intubation occurs when the tube passes too deeply into the right bronchus, causing absent left breath sounds and right-sided chest rise only.
Question 2: What is the recommended tidal volume for ventilated patients to prevent ventilator-induced lung injury?
- 6–8 mL/kg ideal body weight (Correct answer)
- 10–12 mL/kg actual body weight
- 15 mL/kg actual body weight
- 4 mL/kg actual body weight
Correct answer: 6–8 mL/kg ideal body weight
Lung-protective ventilation uses low tidal volumes of 6–8 mL/kg IBW to prevent barotrauma and volutrauma in ventilated patients.
Question 3: Which supraglottic airway device is considered an advanced alternative to BVM ventilation for cardiac arrest?
- King LT or LMA (laryngeal mask airway) (Correct answer)
- Nasopharyngeal airway alone
- Endotracheal tube only
- Oropharyngeal airway
Correct answer: King LT or LMA (laryngeal mask airway)
Supraglottic airways like the King LT and LMA can be rapidly placed without visualization and provide effective ventilation during CPR.
Question 4: Preoxygenation before RSI is performed to extend the apneic window. What SpO2 target indicates adequate preoxygenation?
- SpO2 ≥ 93–95% or higher before paralysis (Correct answer)
- SpO2 > 88%
- SpO2 > 80% on room air
- Any SpO2 above 70%
Correct answer: SpO2 ≥ 93–95% or higher before paralysis
Adequate preoxygenation aims for SpO2 ≥93–95% or higher, ideally 100%, to maximize oxygen reserves and extend the safe apneic period during RSI.
Question 5: Which complication is indicated by a sudden rise in peak airway pressure in a ventilated patient after ETT placement?
- Tension pneumothorax, bronchospasm, or tube obstruction (Correct answer)
- Esophageal intubation
- Hypoventilation
- Pulmonary edema resolution
Correct answer: Tension pneumothorax, bronchospasm, or tube obstruction
Sudden high peak airway pressures after intubation suggest tube obstruction, acute bronchospasm, right mainstem intubation, or tension pneumothorax.
Question 6: What is the primary advantage of video laryngoscopy over direct laryngoscopy in difficult airways?
- Improved glottic visualization without requiring direct line of sight (Correct answer)
- Faster intubation time in all patients
- Eliminates need for NMBA during RSI
- Can be used without preoxygenation
Correct answer: Improved glottic visualization without requiring direct line of sight
Video laryngoscopy provides a magnified indirect view of the glottis via camera, improving visualization in difficult airways without requiring optimal neck positioning.
AMLS Airway Management 2
Which finding indicates right mainstem intubation after ETT placement?