Paramedics Exam Airway Management 5 — Questions and Answers
Question 1: A patient in status epilepticus requires airway management. After establishing BVM ventilation, which RSI induction agent is MOST appropriate?
- Etomidate
- Ketamine (Correct answer)
- Midazolam alone
- Succinylcholine alone
Correct answer: Ketamine
Ketamine provides induction, analgesia, and has anticonvulsant properties, making it particularly appropriate for seizure patients requiring RSI.
Question 2: After inserting an oropharyngeal airway (OPA), the patient begins to gag and vomit. What is the CORRECT action?
- Secure the OPA with tape and suction the airway
- Remove the OPA immediately and place patient in recovery position (Correct answer)
- Advance the OPA deeper to prevent further vomiting
- Inflate the cuff on the OPA
Correct answer: Remove the OPA immediately and place patient in recovery position
An OPA triggering a gag reflex indicates the patient has protective airway reflexes and the device should be removed to prevent aspiration.
Question 3: What is the PRIMARY advantage of using video laryngoscopy over direct laryngoscopy?
- Faster intubation time in all cases
- Improved glottic visualization without requiring direct line of sight (Correct answer)
- Eliminates the need for RSI medications
- Allows intubation without a stylet
Correct answer: Improved glottic visualization without requiring direct line of sight
Video laryngoscopy provides a magnified, indirect view of the glottis on a screen, improving visualization especially in difficult airways.
Question 4: A patient has severe trismus from a seizure and cannot open the mouth. Which airway device is MOST appropriate?
- Oropharyngeal airway
- Endotracheal tube via oral route
- Nasopharyngeal airway (Correct answer)
- King LT airway
Correct answer: Nasopharyngeal airway
A nasopharyngeal airway (NPA) can be inserted through the nose without requiring mouth opening, making it ideal when trismus prevents oral access.
Question 5: During BVM ventilation of a cardiac arrest patient, which rate is recommended for ventilation after an advanced airway is placed?
- 1 breath every 2-3 seconds (20-30/min)
- 1 breath every 6 seconds (10/min) (Correct answer)
- 1 breath every 10 seconds (6/min)
- 1 breath every 15 seconds (4/min)
Correct answer: 1 breath every 6 seconds (10/min)
Once an advanced airway is secured during CPR, ventilations should be delivered at 10 breaths/min (1 every 6 seconds) without pausing compressions.
Question 6: Which is the MOST common complication of prolonged bag-valve-mask ventilation without a gastric tube?
- Pneumothorax
- Gastric distension and aspiration risk (Correct answer)
- Tracheal mucosal injury
- Laryngospasm
Correct answer: Gastric distension and aspiration risk
Positive pressure from BVM ventilation frequently forces air into the stomach, causing distension that elevates the diaphragm and increases aspiration risk.
Question 7: A patient requiring rapid sequence intubation is hypertensive and tachycardic with head trauma. Which induction agent is RELATIVELY contraindicated?
- Etomidate
- Ketamine (Correct answer)
- Propofol
- Midazolam
Correct answer: Ketamine
Ketamine increases intracranial pressure via sympathomimetic effects, making it relatively contraindicated in isolated head trauma with elevated ICP.
Paramedics Exam Airway Management 5
A patient in status epilepticus requires airway management.
After establishing BVM ventilation, which RSI induction agent is MOST appropriate?