In honor of my appearance at Emergency Medicine News' booth at the American College of Emergency Physicians Scientific Assembly in Las Vegas this month, I have put together a quiz to test your knowledge of emergency airway management. The answers come from my previous columns, all of which are available on www.EM-News.com.
If you bring the completed quiz to booth 1821, you will be entered to win one of five copies of the new iBook version of my book, Rapid Sequence Intubation and Rapid Sequence Airway: An Airway911 Guide or our new Airway911 iPhone app. I will be at the booth Wed., Sept. 29, 11 a.m. to 12:30 p.m. Please stop by with your best nightmare airway cases and challenging questions, which I will discuss in future columns.
RSI: June 2006
1. Reasonable options for managing a predicted difficult airway include all of the following except:
- □ Awake oral intubation
- □ Blind nasotracheal intubation
- □ Sedation-facilitated intubation
- □ “Double set-up”
- □ Getting help
Preoxygenation: August 2006
2. After preoxygenation, patients may be divided into three groups. (Fill in the blanks.)
_______ Reserve: Usually no positive pressure ventilation.
_______ Reserve: Emphasize optimal first attempt; may require PPV.
_______ Reserve: Planned positive pressure ventilation.
3. Patients ideally should be preoxygenated with a non-rebreather mask set at 10 to 15 liters per minute for three minutes in what position:
- □ Supine
- □ Prone
- □ Left lateral
- □ 20-degree head elevation
- □ Trendelenburg
Cricoid Pressure: October 2006
4. Cricoid pressure usually improves the laryngeal view during direct laryngoscopy.
5. Cricoid pressure may predispose to aspiration by reducing lower esophageal pressures.
6. In the event the person intubating cannot visualize the cords, cricoid pressure should be ________________. If the view remains inadequate, cricoid pressure should be __________________, and the assistant should assist with __________________________________. (Fill in the blanks.)
The 10 Ps: January 2007
7. List the 10 Ps of rapid sequence intubation:
Interesting 2006 Articles: April 2007
8. Non-Invasive Positive Pressure Ventilation ________ improve preoxygenation prior to intubation.
9. Regarding the article of the year by Levitan, et al, it is clear that bimanual laryngoscopy should be:
- □ Routine
- □ Optional
- □ Avoided
- □ None of the above
The Nightmare Case File: July 2007
10. When I anticipate rapid desaturation, planned positive-pressure ventilation after paralysis and prior to first laryngsocopy is a technique that I:
- □ Routinely use
- □ Occasionally use
- □ Seldom use
- □ Never use
11. When approaching an anticipated difficult airway, clinicians should do all of the following except:
- □ Make a careful plan
- □ Assign all tasks in advance
- □ Position the patient appropriately
- □ Utilize oral and nasal airways
Interesting 2007 Articles: March 2008
12. The most overlooked aspect of post-intubation care is:
- □ Sedation
- □ Cuff pressure
- □ Ventilator settings
- □ Capnography
- □ Blood pressure management
- □ All of the above
13. If getting into trouble on a trauma airway and the patient is becoming hypoxemic yet is a poor candidate for an extraglottic airway, allow some gentle head elevation.
Checklists: May 2008
14. I recommend use of a checklist on:
- □ All intubations
- □ Difficult intubations
- □ Failed intubation
- □ All but crash intubations
Airway Basics: December 2008
15. Atropine should be given routinely for all pediatric patients.
16. Lidocaine is probably more useful for asthmatics than head injury patients.
17. For patients with elevated ICP, generally give:
- □ Lidocaine
- □ Beta-blockers
- □ Defasiculation
- □ Fentanyl
- □ All of the above
Change Your Practice: May 2009
18. Preoxygenation in morbidly obese patients was enhanced by:
- □ NIPPV
- □ Liposuction
- □ Supine positioning
- □ Heavy sedation
19. In the Cochrane review of rocuronium vs. succinylcholine for RSI, there was no statistical difference between:
- □ All groups
- □ Succinylcholine and the rocuronium group that received 0.5 to 0.9 mg/kg
- □ Succinylcholine and the rocuronium group that received 0.9 to 1.2 mg/kg
- □ Any groups
Wanna Bougie? September 2009
20. The bougie is most useful in patients whose Cormack-Lehane grade is:
- □ Grade 1 (full view of cords)
- □ Grade 2 (view of epiglottis and posterior cartilages only)
- □ Grade 3 (view of epiglottis only)
- □ Grade 4 (view of tongue/palate only)
21. Intratracheal position of the bougie may be tactilely confirmed by “clicks” or the inability to pass beyond how many centimeters in an adult?
- □ 20 cm
- □ 30 cm
- □ 40 cm
- □ 50 cm
- □ 60 cm
22. Preshaping of the bougie ______ recommended.
Best 2009 Studies: March 2010
23. According to Mort, critically ill patients should be preoxygenated for how many minutes?
24. According to Hodzovic, et al, flexible fiberoptic intubation through an LMA requires lots of experience.
Stock the Cart: June 2010
25. All of the following should be on every ED airway cart except:
- □ PEEP valve
- □ Bougie
- □ EGA
- □ Scalpel
- □ Retrograde intubation kit
Please provide your name and email address so we may contact if you win. Name _______________________ Email __________________.
The answers to this quiz will appear in the October issue of EMN's monthly enewsletter, EMNow, which can be accessed on www.EM-News.com. Sign up for a free subscription to have it delivered right to your inbox at http://bitly.com/EMNowSignup.
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