DAANCE Airway Management and Oxygen Therapy 4 — Questions and Answers
Question 1: A patient receiving N2O/O2 sedation develops stridor during the procedure. What is the MOST likely cause?
- Laryngospasm (Correct answer)
- Bronchospasm
- Vasovagal syncope
- Hyperventilation
Correct answer: Laryngospasm
Stridor is a high-pitched sound caused by partial upper airway obstruction, most commonly laryngospasm in the dental sedation setting.
Question 2: Which oxygen delivery device provides the HIGHEST fraction of inspired oxygen (FiO2) in a spontaneously breathing patient?
- Simple face mask
- Nasal cannula
- Non-rebreather mask (Correct answer)
- Venturi mask
Correct answer: Non-rebreather mask
A non-rebreather mask with a properly inflated reservoir bag can deliver FiO2 up to 90-95% at 10-15 L/min flow.
Question 3: When performing a jaw thrust maneuver on a patient with suspected cervical spine injury, which technique modification is most appropriate?
- Apply pressure to the forehead while lifting the chin
- Displace the mandible anteriorly without head tilt (Correct answer)
- Rotate the head laterally to open the airway
- Apply cricoid pressure simultaneously
Correct answer: Displace the mandible anteriorly without head tilt
The jaw thrust without head tilt displaces the mandible forward to open the airway while maintaining cervical spine neutrality.
Question 4: A nasal cannula delivering oxygen at 4 L/min provides an approximate FiO2 of:
- 24%
- 32%
- 36% (Correct answer)
- 44%
Correct answer: 36%
Each liter per minute of nasal cannula flow adds approximately 4% FiO2 above room air (21%), so 4 L/min ≈ 37% (commonly rounded to 36%).
Question 5: During N2O/O2 sedation, the minimum oxygen concentration that must be maintained is:
- 20%
- 25% (Correct answer)
- 30%
- 50%
Correct answer: 25%
A minimum of 25% oxygen must be delivered at all times during N2O/O2 sedation to prevent hypoxia, per DAANCE and AAPD guidelines.
Question 6: Which clinical sign BEST indicates adequate bag-mask ventilation is being delivered?
- Audible gastric gurgling
- Visible chest rise with each breath (Correct answer)
- SpO2 reading of 95%
- End-tidal CO2 waveform present
Correct answer: Visible chest rise with each breath
Visible bilateral chest rise with each delivered breath is the primary clinical confirmation of effective bag-mask ventilation.
Question 7: A patient's SpO2 drops from 98% to 91% during sedation. After repositioning the airway, the NEXT intervention is:
- Administer flumazenil immediately
- Increase supplemental oxygen flow rate (Correct answer)
- Perform cricothyrotomy
- Administer epinephrine
Correct answer: Increase supplemental oxygen flow rate
After airway repositioning, increasing supplemental oxygen delivery is the next appropriate step before escalating to reversal agents or advanced interventions.
DAANCE Airway Management and Oxygen Therapy 4
A patient receiving N2O/O2 sedation develops stridor during the procedure.
What is the MOST likely cause?