AMLS Airway Management 1 — Questions and Answers
Question 1: Which airway adjunct is preferred for an unconscious patient without a gag reflex who cannot be intubated immediately?
- Oropharyngeal airway (OPA) (Correct answer)
- Nasopharyngeal airway (NPA)
- Bag-valve-mask alone
- Endotracheal tube
Correct answer: Oropharyngeal airway (OPA)
An OPA is appropriate for unconscious patients without a gag reflex to maintain tongue displacement and allow effective BVM ventilation.
Question 2: Which is the most reliable method to confirm correct endotracheal tube placement?
- Waveform capnography showing consistent ETCO2 waveform (Correct answer)
- Bilateral breath sounds on auscultation
- Chest rise visualization during ventilation
- Chest X-ray only
Correct answer: Waveform capnography showing consistent ETCO2 waveform
Continuous waveform capnography is the gold standard for confirming and monitoring ETT placement, as it detects every breath delivered to the lungs.
Question 3: In rapid sequence intubation (RSI), what is the purpose of the defasciculating dose of a non-depolarizing agent before succinylcholine?
- Prevent fasciculations and associated intracranial and intraocular pressure rise (Correct answer)
- Speed onset of succinylcholine
- Prevent bronchospasm
- Reduce risk of bradycardia
Correct answer: Prevent fasciculations and associated intracranial and intraocular pressure rise
A defasciculating dose of a non-depolarizing NMBA blunts the muscle fasciculations from succinylcholine, which can transiently raise ICP and IOP.
Question 4: Which neuromuscular blocking agent is contraindicated in burn patients, crush injury, or hyperkalemia due to risk of fatal hyperkalemia?
- Succinylcholine (Correct answer)
- Rocuronium
- Vecuronium
- Cisatracurium
Correct answer: Succinylcholine
Succinylcholine causes potassium release from acetylcholine receptors; in burns, crush injuries, or upregulated receptors, this can cause fatal hyperkalemia.
Question 5: What is the LEMON law mnemonic used for in airway management?
- Predicting difficult laryngoscopy and intubation (Correct answer)
- Assessing adequacy of mask ventilation
- Choosing the correct ET tube size
- Determining need for surgical airway
Correct answer: Predicting difficult laryngoscopy and intubation
LEMON (Look externally, Evaluate 3-3-2, Mallampati, Obstruction, Neck mobility) is used to predict difficult laryngoscopy before RSI.
Question 6: A patient in respiratory failure cannot be intubated and cannot be mask-ventilated. What is the definitive emergency intervention?
- Cricothyrotomy (surgical or needle) (Correct answer)
- Repeat laryngoscopy attempts
- Nasotracheal intubation only
- Continue BVM indefinitely
Correct answer: Cricothyrotomy (surgical or needle)
In a 'can't intubate, can't oxygenate' (CICO) scenario, cricothyrotomy provides emergency surgical airway access.
AMLS Airway Management 1
Which airway adjunct is preferred for an unconscious patient without a gag reflex who cannot be intubated immediately?