Air Methods Critical Care Review Airway
Anesthesia and Analgesics Exam With
100% Correct Answers
You are transporting a traumatic patient who has been in the Trauma ICU with significant
injuries for 1 week. He has not developed sepsis with the following VS:
BP: 88/55
P: 120 Sinus tach without ectopy
RR: 10
SpO2: 100%
Temperature: 102.1F
ABGs
pH: 7.1
PaCO2: 50mmHg
PaO2: 340 mmHg
HCO3: 30mEq/L
What would you expect with this patient's O2 Hemoglobin dissociation curve? - CORRECT
ANSWER✔✔The curve will be shifted right
You are intubating a 54 year old female who is 5'2" and weighs 235lbs. While preforming a
mallampati assessment, you notice her soft palate and major part of uvula present. You could
classify her as a class: - CORRECT ANSWER✔✔II
,Structures seen with Class I Mallampati assessment - CORRECT ANSWER✔✔Soft palete, uvula,
fauces, pillars visible
Structures seen with Class II Mallampati assessment - CORRECT ANSWER✔✔Soft Palate, major
part of uvula, fauces visible
Structures seen with Class III Mallampati assessment - CORRECT ANSWER✔✔Soft palate, base
of uvula visible
Structures seen with Class IV Mallampati assessment - CORRECT ANSWER✔✔Only hard palate
visible
What can cause a left shift in the oxyhemoglobin dissociation curve?
ARDS
A pt. who received mass transfusion
Respiratory Acidosis
Sepsis - CORRECT ANSWER✔✔A patient who received mass transfusion
Would shift left due to increased oxygen carrying. ARDS, Respiratory acidosis, and sepsis all are
associated with acidosis, lower pH, higher levels of CO2, which would cause a right shift
When it comes to making ATP during aerobic respiration, why is oxygen necessary? - CORRECT
ANSWER✔✔Oxygen is the final electron acceptor in the electron transport chain
High-energy electrons go through the electron transport chain in a series of exe3rgonic redox
reactions. Ultimately used to produce ATP.
Which of the following methods is the least effective way to confirm endotracheal tube
placement?
,End Tidal CO2 capnometry
Fogging in the tube
Direct visualization between the vocal cords
Bilateral equal lung sounds - CORRECT ANSWER✔✔Fogging in the tube
What is the gold-standard to confirm ETT placement? - CORRECT ANSWER✔✔End Tidal CO2
capnometry
What is Graham's law? - CORRECT ANSWER✔✔Gas will diffuse from high pressure to low
pressure
Higher O2 concentration in alveoli will diffuse to capillaries, which has lower concentrations of
O2
Acronym to consider for surgical cric considerations - CORRECT ANSWER✔✔SMART
Surgery of Neck
Mass
Access to the neck - obesity, Limited ROM
Radiation
Tumor
Acronym to consider when predicting a difficult airway - CORRECT ANSWER✔✔HEAVEN
Hypoxemia
Extremes of size - obese pt, petite pt.
Anatomic disruption/obstruction
Vomit/blood/fluid
Exsanguination- bled out so much they can't keep SpO2 up
, Neck mobility/neuro injury
Mallampati score vs Cormack-Lenane score - CORRECT ANSWER✔✔Mallampati is direct
visualization of the oral cavity and oropharynx
Cormack-Lenane score is direct visualization of the pharynx and glottis with laryngoscope
How do non-depolarizing paralytic agents, like rocuronium, work? - CORRECT ANSWER✔✔They
compete with acetylcholine, blocking nicotinic receptors
Non-depolarizing neuromuscular blocking drugs do not depolarize receptions. They compete
with Ach for binding sites on nicotinic alpha subunits, causing skeletal relaxation
You prepare to intubate a pediatric patient experiencing severe bronchospasm. Which induction
agent will you utilize? - CORRECT ANSWER✔✔Ketamine
Ketamine is the induction agent of choice for reactive airway disease due to its
sympathomimetic and bronchodilatory effects.
Which is the shortest acting paralytic? - CORRECT ANSWER✔✔Succinylcholine
On a scene call with a 63 year old male patient, you elect to intubate him after a failed trial of
BPAP for fluid overload and respiratory failure. Your patient has a hx of hypertension, diabetes,
end stage renal disease and missed his last 3 dialysis appointments. What paralytic would be
contraindicated for this patient? - CORRECT ANSWER✔✔Succinylcholine
Which neuromuscular blocking agent is classified as depolarizing? - CORRECT
ANSWER✔✔Succinylcholine
Anesthesia and Analgesics Exam With
100% Correct Answers
You are transporting a traumatic patient who has been in the Trauma ICU with significant
injuries for 1 week. He has not developed sepsis with the following VS:
BP: 88/55
P: 120 Sinus tach without ectopy
RR: 10
SpO2: 100%
Temperature: 102.1F
ABGs
pH: 7.1
PaCO2: 50mmHg
PaO2: 340 mmHg
HCO3: 30mEq/L
What would you expect with this patient's O2 Hemoglobin dissociation curve? - CORRECT
ANSWER✔✔The curve will be shifted right
You are intubating a 54 year old female who is 5'2" and weighs 235lbs. While preforming a
mallampati assessment, you notice her soft palate and major part of uvula present. You could
classify her as a class: - CORRECT ANSWER✔✔II
,Structures seen with Class I Mallampati assessment - CORRECT ANSWER✔✔Soft palete, uvula,
fauces, pillars visible
Structures seen with Class II Mallampati assessment - CORRECT ANSWER✔✔Soft Palate, major
part of uvula, fauces visible
Structures seen with Class III Mallampati assessment - CORRECT ANSWER✔✔Soft palate, base
of uvula visible
Structures seen with Class IV Mallampati assessment - CORRECT ANSWER✔✔Only hard palate
visible
What can cause a left shift in the oxyhemoglobin dissociation curve?
ARDS
A pt. who received mass transfusion
Respiratory Acidosis
Sepsis - CORRECT ANSWER✔✔A patient who received mass transfusion
Would shift left due to increased oxygen carrying. ARDS, Respiratory acidosis, and sepsis all are
associated with acidosis, lower pH, higher levels of CO2, which would cause a right shift
When it comes to making ATP during aerobic respiration, why is oxygen necessary? - CORRECT
ANSWER✔✔Oxygen is the final electron acceptor in the electron transport chain
High-energy electrons go through the electron transport chain in a series of exe3rgonic redox
reactions. Ultimately used to produce ATP.
Which of the following methods is the least effective way to confirm endotracheal tube
placement?
,End Tidal CO2 capnometry
Fogging in the tube
Direct visualization between the vocal cords
Bilateral equal lung sounds - CORRECT ANSWER✔✔Fogging in the tube
What is the gold-standard to confirm ETT placement? - CORRECT ANSWER✔✔End Tidal CO2
capnometry
What is Graham's law? - CORRECT ANSWER✔✔Gas will diffuse from high pressure to low
pressure
Higher O2 concentration in alveoli will diffuse to capillaries, which has lower concentrations of
O2
Acronym to consider for surgical cric considerations - CORRECT ANSWER✔✔SMART
Surgery of Neck
Mass
Access to the neck - obesity, Limited ROM
Radiation
Tumor
Acronym to consider when predicting a difficult airway - CORRECT ANSWER✔✔HEAVEN
Hypoxemia
Extremes of size - obese pt, petite pt.
Anatomic disruption/obstruction
Vomit/blood/fluid
Exsanguination- bled out so much they can't keep SpO2 up
, Neck mobility/neuro injury
Mallampati score vs Cormack-Lenane score - CORRECT ANSWER✔✔Mallampati is direct
visualization of the oral cavity and oropharynx
Cormack-Lenane score is direct visualization of the pharynx and glottis with laryngoscope
How do non-depolarizing paralytic agents, like rocuronium, work? - CORRECT ANSWER✔✔They
compete with acetylcholine, blocking nicotinic receptors
Non-depolarizing neuromuscular blocking drugs do not depolarize receptions. They compete
with Ach for binding sites on nicotinic alpha subunits, causing skeletal relaxation
You prepare to intubate a pediatric patient experiencing severe bronchospasm. Which induction
agent will you utilize? - CORRECT ANSWER✔✔Ketamine
Ketamine is the induction agent of choice for reactive airway disease due to its
sympathomimetic and bronchodilatory effects.
Which is the shortest acting paralytic? - CORRECT ANSWER✔✔Succinylcholine
On a scene call with a 63 year old male patient, you elect to intubate him after a failed trial of
BPAP for fluid overload and respiratory failure. Your patient has a hx of hypertension, diabetes,
end stage renal disease and missed his last 3 dialysis appointments. What paralytic would be
contraindicated for this patient? - CORRECT ANSWER✔✔Succinylcholine
Which neuromuscular blocking agent is classified as depolarizing? - CORRECT
ANSWER✔✔Succinylcholine
