PARAMEDIC FISDAP AIRWAY FINAL
REVIEW QUESTIONS AND ANSWERS
WITH COMPLETE SOLUTIONS 100%
CORRECT RATED A+
Question 1
What are the primary indications for performing Nasotracheal Intubation
(Blind Nasotracheal Intubation / BNTI)?
Answer: Spontaneously breathing, responsive patients with altered mental
status (AMS), an intact gag reflex, and acute respiratory failure caused by
conditions like severe COPD, asthma, or pulmonary edema.
Clinical Notes & Safety Guidelines:
Spontaneous Breathing Required: The patient must be breathing
spontaneously so the clinician can listen to breath sounds through the tube
during insertion to guide it into the trachea.
Preserved Airway Reflexes: Indicated when the patient retains an intact
gag reflex, making standard direct orotracheal intubation without paralytics
(RSI) difficult or impossible.
Absolute Contraindication: Mid-face trauma or suspected basilar skull
fractures (due to the risk of intracranial placement).
Question 2
What are the primary indications and principles for suctioning the airway?
Answer: When the patient's mouth, pharynx, or endotracheal/tracheostomy
tube is obstructed by fluids (vomitus, blood, or thick secretions) to maintain a
clear airway and prevent aspiration prior to or during positive-pressure
ventilation.
Clinical Notes & Safety Guidelines:
Suctioning Time Limits: Limit suctioning to a maximum of 10 to 15
seconds for adults (5–10 seconds for pediatrics) to avoid secondary hypoxia.
, Technique: Apply suction only upon withdrawal of the catheter while
rotating it between your thumb and forefinger.
Pre- and Post-Oxygenation: Always hyperoxygenate the patient before and
immediately after suctioning.
Question 3
What are the key signs and symptoms associated with lower airway trauma
or injury?
Answer: Dyspnea, tachypnea, cough, hypoxia, wheezing, crackles (rales),
rhonchi, chest wall retractions, and hemoptysis.
Clinical Notes:
Lower airway injuries affect structures below the vocal cords (trachea,
bronchi, and pulmonary tissue).
Note on Stridor: Stridor is primarily an upper airway sound (caused by
high-velocity airflow through a narrowed supraglottic/glottic space),
whereas lower airway injuries produce adventitious sounds like wheezing
(bronchospasm) or crackles/rhonchi (fluid/mucus in small airways).
Question 4
What are the key signs and symptoms of a Tension Pneumothorax?
Answer: Progressive severe dyspnea, marked hypoxia, absent or severely
diminished breath sounds on the affected side, hypotension (obstructive shock),
tachycardia, altered mental status (AMS), jugular venous distension (JVD), and
late tracheal deviation away from the injured side.
Clinical Notes:
Tension pneumothorax is a life-threatening surgical emergency occurring
when trapped air in the pleural space creates positive pressure, collapsing the
ipsilateral lung and shifting the mediastinum, which compresses the vena
cava and severely reduces venous return to the heart.
Immediate intervention is needle chest decompression before obtaining
imaging or delayed transport.
Question 5
REVIEW QUESTIONS AND ANSWERS
WITH COMPLETE SOLUTIONS 100%
CORRECT RATED A+
Question 1
What are the primary indications for performing Nasotracheal Intubation
(Blind Nasotracheal Intubation / BNTI)?
Answer: Spontaneously breathing, responsive patients with altered mental
status (AMS), an intact gag reflex, and acute respiratory failure caused by
conditions like severe COPD, asthma, or pulmonary edema.
Clinical Notes & Safety Guidelines:
Spontaneous Breathing Required: The patient must be breathing
spontaneously so the clinician can listen to breath sounds through the tube
during insertion to guide it into the trachea.
Preserved Airway Reflexes: Indicated when the patient retains an intact
gag reflex, making standard direct orotracheal intubation without paralytics
(RSI) difficult or impossible.
Absolute Contraindication: Mid-face trauma or suspected basilar skull
fractures (due to the risk of intracranial placement).
Question 2
What are the primary indications and principles for suctioning the airway?
Answer: When the patient's mouth, pharynx, or endotracheal/tracheostomy
tube is obstructed by fluids (vomitus, blood, or thick secretions) to maintain a
clear airway and prevent aspiration prior to or during positive-pressure
ventilation.
Clinical Notes & Safety Guidelines:
Suctioning Time Limits: Limit suctioning to a maximum of 10 to 15
seconds for adults (5–10 seconds for pediatrics) to avoid secondary hypoxia.
, Technique: Apply suction only upon withdrawal of the catheter while
rotating it between your thumb and forefinger.
Pre- and Post-Oxygenation: Always hyperoxygenate the patient before and
immediately after suctioning.
Question 3
What are the key signs and symptoms associated with lower airway trauma
or injury?
Answer: Dyspnea, tachypnea, cough, hypoxia, wheezing, crackles (rales),
rhonchi, chest wall retractions, and hemoptysis.
Clinical Notes:
Lower airway injuries affect structures below the vocal cords (trachea,
bronchi, and pulmonary tissue).
Note on Stridor: Stridor is primarily an upper airway sound (caused by
high-velocity airflow through a narrowed supraglottic/glottic space),
whereas lower airway injuries produce adventitious sounds like wheezing
(bronchospasm) or crackles/rhonchi (fluid/mucus in small airways).
Question 4
What are the key signs and symptoms of a Tension Pneumothorax?
Answer: Progressive severe dyspnea, marked hypoxia, absent or severely
diminished breath sounds on the affected side, hypotension (obstructive shock),
tachycardia, altered mental status (AMS), jugular venous distension (JVD), and
late tracheal deviation away from the injured side.
Clinical Notes:
Tension pneumothorax is a life-threatening surgical emergency occurring
when trapped air in the pleural space creates positive pressure, collapsing the
ipsilateral lung and shifting the mediastinum, which compresses the vena
cava and severely reduces venous return to the heart.
Immediate intervention is needle chest decompression before obtaining
imaging or delayed transport.
Question 5
