CPR Advanced Airway Management 2 — Questions and Answers
Question 1: When performing a rapid sequence intubation (RSI), which medication is classified as a depolarizing neuromuscular blocking agent?
- Rocuronium
- Vecuronium
- Succinylcholine (Correct answer)
- Pancuronium
Correct answer: Succinylcholine
Succinylcholine is the only depolarizing neuromuscular blocking agent commonly used in RSI, causing brief fasciculations before paralysis.
Question 2: A patient with a suspected C-spine injury requires intubation. Which technique is most appropriate?
- Blind nasotracheal intubation
- Manual inline stabilization with orotracheal intubation (Correct answer)
- Cricothyrotomy immediately
- Postpone intubation until hospital arrival
Correct answer: Manual inline stabilization with orotracheal intubation
Manual inline stabilization (MILS) during orotracheal intubation is the preferred technique to maintain cervical spine alignment while securing the airway.
Question 3: Which waveform capnography reading indicates esophageal intubation?
- Consistent square wave at 35-45 mmHg
- Shark fin waveform
- Flat line with no CO2 detected (Correct answer)
- Elevated plateau above 50 mmHg
Correct answer: Flat line with no CO2 detected
Esophageal intubation produces a flat-line capnography reading with no CO2 detected after the first breath or two.
Question 4: The Sellick maneuver (cricoid pressure) is applied during RSI primarily to:
- Improve laryngoscope view
- Prevent passive regurgitation of gastric contents (Correct answer)
- Open the glottis wider
- Reduce the dose of sedative needed
Correct answer: Prevent passive regurgitation of gastric contents
Cricoid pressure compresses the esophagus against the vertebral body to reduce passive regurgitation and aspiration risk during intubation.
Question 5: A paramedic is ventilating a 70 kg adult with a BVM. What is the appropriate tidal volume per breath?
- 200-300 mL
- 400-600 mL (Correct answer)
- 800-1000 mL
- 1200-1500 mL
Correct answer: 400-600 mL
For an adult, BVM ventilation should deliver approximately 400–600 mL tidal volume (6–8 mL/kg) to avoid gastric inflation and barotrauma.
Question 6: Which laryngoscope blade type is designed to be placed in the vallecula to indirectly lift the epiglottis?
- Miller blade
- Macintosh blade (Correct answer)
- Wisconsin blade
- Phillips blade
Correct answer: Macintosh blade
The Macintosh (curved) blade is placed in the vallecula, using traction on the hyoepiglottic ligament to indirectly elevate the epiglottis.
Question 7: After successful intubation, the tube is taped at the 23 cm mark at the lips in an average adult male. This placement suggests the tube tip is:
- Too shallow — should be at 27 cm
- Correctly positioned in the mid-trachea (Correct answer)
- In the right mainstem bronchus
- At the carina
Correct answer: Correctly positioned in the mid-trachea
For adult males, securing the ETT at 21–23 cm at the lips generally places the tip in the mid-trachea, approximately 3–4 cm above the carina.
CPR Advanced Airway Management 2
When performing a rapid sequence intubation (RSI), which medication is classified as a depolarizing neuromuscular blocking agent?