Airway Management & Emergency Response Flashcards

A patient with a known difficult airway requires emergent intubation. The 'can't intubate, can't oxygenate' (CICO) scenario is declared. What is the immediate next step after failed oxygenation with a supraglottic airway?

Answer: Perform front-of-neck access (surgical airway)

In a CICO emergency, front-of-neck access (cricothyrotomy or surgical tracheotomy) is mandatory when oxygenation cannot be achieved by other means.

When using video laryngoscopy with a hyperangulated blade, the anesthesiologist achieves an excellent glottic view but cannot advance the endotracheal tube. What is the most likely cause?

Answer: Acute angle between blade geometry and tracheal axis requires a stylet with matching curvature

Hyperangulated video laryngoscope blades create a sharp anterior angle requiring a pre-shaped stylet that matches the blade curve to navigate the tube into the trachea.

During rapid sequence induction, succinylcholine 1.5 mg/kg is administered. How long should the anesthesiologist wait before intubating to ensure maximum fasciculation and relaxation?

Answer: 45–60 seconds

Optimal intubating conditions after succinylcholine occur at approximately 45–60 seconds, coinciding with peak neuromuscular blockade.

A patient develops subcutaneous emphysema and decreasing SpO2 shortly after endotracheal intubation. Breath sounds are absent on the left. The most likely diagnosis is:

Answer: Right main-stem bronchus intubation

Right main-stem intubation is the most common endobronchial intubation because the right bronchus has a less acute angle from the carina, resulting in absent left breath sounds.

Which capnography waveform pattern is most consistent with a bronchospasm during mechanical ventilation?

Answer: Shark-fin (sloping plateau) waveform with elevated EtCO2

Bronchospasm causes prolonged expiration and uneven gas emptying, producing the characteristic shark-fin capnography waveform with elevated end-tidal CO2.

A patient with Ludwig's angina presents for emergency airway management. Which approach is considered safest as the initial strategy?

Answer: Awake flexible bronchoscopic intubation with topical anesthesia

Awake flexible bronchoscopic intubation preserves spontaneous respiration and airway patency, making it the safest initial technique in the setting of severe submandibular infection and airway distortion.

During a cricothyrotomy using the Seldinger technique, the anesthesiologist cannot pass the guidewire easily. What should be done first?

Answer: Confirm needle position by aspirating air, then rotate the needle bevel

Confirming intratracheal needle placement by free aspiration of air and adjusting bevel orientation is the first step before re-attempting wire advancement.