ADVANCED AIRWAY MANAGEMENT TECHNIQUES
AND PROTOCOLS INSIDER ACCESS OF 2025/2026
EXAM QUESTIONS WITH 100% SUCCESS RATE
What is Rapid Sequence Intubation (RSI)? - An airway management technique that induces
immediate unresponsiveness and muscular relaxation, making it the fastest and most effective
means of controlling the emergency airway.
What are the reasons to perform Rapid Sequence Intubation (RSI)? - 1. Urgent need to go to the
OR with close proximity to OT. 2. Need for neuroprotection (target PaCO2 35-40 mmHg). 3.
Impending obstruction (e.g., airway burn, penetrating neck injury). 4. Combativeness. 5.
Anatomically or pathologically difficult airway. 6. Pediatric cases (especially <5 years of age). 7.
Poorly functioning team.
What are the reasons not to perform Rapid Sequence Intubation (RSI)? - 1. Lack of airway
protection despite patency. 2. Hypoventilation. 3. Hypoxia. 4. Prolonged transfer. 5. Lack of
requisite skills among the team. 6. Emergency surgical airway is not possible.
What are the steps for Rapid Sequence Intubation (RSI)? - 1. Assess, gather equipment, and
assign roles. 2. Administer high-flow oxygen (preoxygenation). 3. Administer specific
medications (physiologic optimization). 4. Protect spine and position for airway alignment. 5.
Intubate and confirm placement. 6. Secure, ventilate, and administer post-intubation care.
What is the purpose of a checklist in the intubation process? - A checklist serves as a cognitive
aid that lists essential actions required for intubation, helping to reduce errors and improve team
function in high-risk situations.
What does the mnemonic 'SOAP ME' stand for in airway management preparation? - Suction,
Oxygen, Airways, Positioning, Monitors & Meds, EtCO2.
What is the recommended positioning for intubation? - Ear-to-sternal notch position.
,What equipment is included in the 'SOAP ME' mnemonic for airway management? - 1. Suction:
At least one working suction. 2. Oxygen: NRBM and BVM attached to 15 LPM of O2. 3.
Airways: ET tubes of appropriate sizes. 4. Positioning: Proper alignment for intubation. 5.
Monitors & Meds: Cardiac monitor, pulse ox, BP cuff, and medications ready. 6. EtCO2:
Continuous monitoring or color-change device.
What should be done to ensure the ET tube is ready for intubation? - Test the balloon by filling it
with 10 cc of air and ensure the stylet is placed inside the ET tube for rigidity.
What is the significance of using a checklist in emergency intubation? - Checklists help clarify
priorities and prompt better team functioning, reducing the incidence of serious complications.
What are the features that may predict a difficult airway? - Facial swelling or trauma, presence of
dentures, or C-spine immobilization.
What is the role of prehospital airways in predicting difficult airways? - Prehospital airways are
automatically considered difficult airways.
What is the purpose of administering high-flow oxygen during Rapid Sequence Intubation? - To
preoxygenate the patient and improve oxygenation before intubation.
What should be done if intubation is not possible? - Have a surgical cric kit available as a
backup.
What is the target PaCO2 range for neuroprotection during intubation? - 35-40 mmHg.
What are the types of intubation techniques mentioned? - Rapid Sequence Intubation (RSI),
Delayed Sequence Intubation (DSI), Medication Assisted Intubation (MAI).
What is the primary goal of Rapid Sequence Intubation? - To quickly secure the airway in
emergency situations.
,What should be done to confirm successful intubation? - Use continuous EtCO2 monitoring or a
color-change device.
What is the importance of positioning during intubation? - Proper positioning aligns the airway
for easier intubation and reduces the risk of complications.
What is the recommended blade type for intubation in adults? - Mac 3 or 4 for curved blades,
and Miller 2, 3, or 4 for straight blades.
What should be done with the laryngoscope handle before intubation? - Attach the blade and
ensure the light source works, but do not keep it attached until ready to intubate.
What is the significance of having a video laryngoscope at the bedside? - It serves as an
alternative tool to assist in intubation, especially in difficult cases.
What is the recommended oxygen delivery method for apneic oxygenation? - Use nasal prongs
along with NRBM and BVM attached to high-flow oxygen.
What equipment should be readily available at the bedside for intubation? - Laryngoscope, LMA
(Laryngeal Mask Airway), and bougie.
What is the ideal positioning for intubation? - Ear-to-sternal notch position.
What monitors and medications should be prepared prior to intubation? - Cardiac monitor, pulse
oximeter, BP cuff on the opposite arm with IV access; medications drawn up and ready.
What device is used to confirm successful intubation? - Continuous EtCO2 monitor or at least a
color-change device.
, What factors indicate a potentially difficult airway? - Facial swelling or trauma, presence of
dentures, or C-spine immobilization.
What is the 3-3-2 rule used for? - To assess mouth opening and larynx position prior to
intubation.
What are the three measurements in the 3-3-2 rule? - 3 fingerbreadths of mouth opening, 3
fingerbreadths from the mandible to neck, and 2 fingerbreadths from neck to thyroid.
What is the Mallampati classification used for? - To evaluate oral accessibility and predict the
risk of difficult intubation.
What are the four grades of the Mallampati score? - I: Soft palate, uvula, and pillars visible; II:
Soft palate and part of uvula visible; III: Only soft palate visible; IV: Only hard palate visible.
What should be included in the intubation team plan? - Clear role assignments, a fallback plan
for unsuccessful intubation, and situational awareness strategies.
What tasks should be assigned for a difficult airway situation? - Oxygenation plan, failed airway
algorithm, video laryngoscope, extraglottic airway, cricothyroidotomy kit, pre-oxygenation,
intubation, assisting the intubator, drug administration, ELM, manual in-line stabilization, and
pulse oximetry monitoring.
What is the goal of preoxygenation? - To establish a reservoir of oxygen in the lungs, delaying
arterial hemoglobin desaturation during intubation.
What is the emergency preoxygenation algorithm if the patient was on CPAP? - Leave the nasal
cannula in place and use the CPAP mask as the BVM at 15 liters/minute.
What is the target SpO2 during preoxygenation? - As close to 100% as possible.
AND PROTOCOLS INSIDER ACCESS OF 2025/2026
EXAM QUESTIONS WITH 100% SUCCESS RATE
What is Rapid Sequence Intubation (RSI)? - An airway management technique that induces
immediate unresponsiveness and muscular relaxation, making it the fastest and most effective
means of controlling the emergency airway.
What are the reasons to perform Rapid Sequence Intubation (RSI)? - 1. Urgent need to go to the
OR with close proximity to OT. 2. Need for neuroprotection (target PaCO2 35-40 mmHg). 3.
Impending obstruction (e.g., airway burn, penetrating neck injury). 4. Combativeness. 5.
Anatomically or pathologically difficult airway. 6. Pediatric cases (especially <5 years of age). 7.
Poorly functioning team.
What are the reasons not to perform Rapid Sequence Intubation (RSI)? - 1. Lack of airway
protection despite patency. 2. Hypoventilation. 3. Hypoxia. 4. Prolonged transfer. 5. Lack of
requisite skills among the team. 6. Emergency surgical airway is not possible.
What are the steps for Rapid Sequence Intubation (RSI)? - 1. Assess, gather equipment, and
assign roles. 2. Administer high-flow oxygen (preoxygenation). 3. Administer specific
medications (physiologic optimization). 4. Protect spine and position for airway alignment. 5.
Intubate and confirm placement. 6. Secure, ventilate, and administer post-intubation care.
What is the purpose of a checklist in the intubation process? - A checklist serves as a cognitive
aid that lists essential actions required for intubation, helping to reduce errors and improve team
function in high-risk situations.
What does the mnemonic 'SOAP ME' stand for in airway management preparation? - Suction,
Oxygen, Airways, Positioning, Monitors & Meds, EtCO2.
What is the recommended positioning for intubation? - Ear-to-sternal notch position.
,What equipment is included in the 'SOAP ME' mnemonic for airway management? - 1. Suction:
At least one working suction. 2. Oxygen: NRBM and BVM attached to 15 LPM of O2. 3.
Airways: ET tubes of appropriate sizes. 4. Positioning: Proper alignment for intubation. 5.
Monitors & Meds: Cardiac monitor, pulse ox, BP cuff, and medications ready. 6. EtCO2:
Continuous monitoring or color-change device.
What should be done to ensure the ET tube is ready for intubation? - Test the balloon by filling it
with 10 cc of air and ensure the stylet is placed inside the ET tube for rigidity.
What is the significance of using a checklist in emergency intubation? - Checklists help clarify
priorities and prompt better team functioning, reducing the incidence of serious complications.
What are the features that may predict a difficult airway? - Facial swelling or trauma, presence of
dentures, or C-spine immobilization.
What is the role of prehospital airways in predicting difficult airways? - Prehospital airways are
automatically considered difficult airways.
What is the purpose of administering high-flow oxygen during Rapid Sequence Intubation? - To
preoxygenate the patient and improve oxygenation before intubation.
What should be done if intubation is not possible? - Have a surgical cric kit available as a
backup.
What is the target PaCO2 range for neuroprotection during intubation? - 35-40 mmHg.
What are the types of intubation techniques mentioned? - Rapid Sequence Intubation (RSI),
Delayed Sequence Intubation (DSI), Medication Assisted Intubation (MAI).
What is the primary goal of Rapid Sequence Intubation? - To quickly secure the airway in
emergency situations.
,What should be done to confirm successful intubation? - Use continuous EtCO2 monitoring or a
color-change device.
What is the importance of positioning during intubation? - Proper positioning aligns the airway
for easier intubation and reduces the risk of complications.
What is the recommended blade type for intubation in adults? - Mac 3 or 4 for curved blades,
and Miller 2, 3, or 4 for straight blades.
What should be done with the laryngoscope handle before intubation? - Attach the blade and
ensure the light source works, but do not keep it attached until ready to intubate.
What is the significance of having a video laryngoscope at the bedside? - It serves as an
alternative tool to assist in intubation, especially in difficult cases.
What is the recommended oxygen delivery method for apneic oxygenation? - Use nasal prongs
along with NRBM and BVM attached to high-flow oxygen.
What equipment should be readily available at the bedside for intubation? - Laryngoscope, LMA
(Laryngeal Mask Airway), and bougie.
What is the ideal positioning for intubation? - Ear-to-sternal notch position.
What monitors and medications should be prepared prior to intubation? - Cardiac monitor, pulse
oximeter, BP cuff on the opposite arm with IV access; medications drawn up and ready.
What device is used to confirm successful intubation? - Continuous EtCO2 monitor or at least a
color-change device.
, What factors indicate a potentially difficult airway? - Facial swelling or trauma, presence of
dentures, or C-spine immobilization.
What is the 3-3-2 rule used for? - To assess mouth opening and larynx position prior to
intubation.
What are the three measurements in the 3-3-2 rule? - 3 fingerbreadths of mouth opening, 3
fingerbreadths from the mandible to neck, and 2 fingerbreadths from neck to thyroid.
What is the Mallampati classification used for? - To evaluate oral accessibility and predict the
risk of difficult intubation.
What are the four grades of the Mallampati score? - I: Soft palate, uvula, and pillars visible; II:
Soft palate and part of uvula visible; III: Only soft palate visible; IV: Only hard palate visible.
What should be included in the intubation team plan? - Clear role assignments, a fallback plan
for unsuccessful intubation, and situational awareness strategies.
What tasks should be assigned for a difficult airway situation? - Oxygenation plan, failed airway
algorithm, video laryngoscope, extraglottic airway, cricothyroidotomy kit, pre-oxygenation,
intubation, assisting the intubator, drug administration, ELM, manual in-line stabilization, and
pulse oximetry monitoring.
What is the goal of preoxygenation? - To establish a reservoir of oxygen in the lungs, delaying
arterial hemoglobin desaturation during intubation.
What is the emergency preoxygenation algorithm if the patient was on CPAP? - Leave the nasal
cannula in place and use the CPAP mask as the BVM at 15 liters/minute.
What is the target SpO2 during preoxygenation? - As close to 100% as possible.
