AIR METHODS CRITICAL CARE REVIEW AIRWAY ANESTHESIA AND ANALGESICS WITH ANSWERS RATED A+

AIR METHODS CRITICAL CARE
REVIEW AIRWAY ANESTHESIA AND
ANALGESICS WITH ANSWERS RATED
A+
YouwarewtransportingwawtraumaticwpatientwwhowhaswbeenwinwthewTraumawICUwwithwsignificantwinju
rieswforw1wweek.wHewhaswnotwdevelopedwsepsiswwithwthewfollowingwVS:



BP:w88/55

P:w120wSinuswtachwwithoutwectopy

RR:w10

SpO2:w100%

Temperature:w102.1F

ABGs

pH:w7.1

PaCO2:w50mmHg

PaO2:w340wmmHg

HCO3:w30mEq/L



Whatwwouldwyouwexpectwwithwthiswpatient'swO2wHemoglobinwdissociationwcurve?w-
wCORRECTwANSWERSwThewcurvewwillwbewshiftedwright




Youwarewintubatingwaw54wyearwoldwfemalewwhowisw5'2"wandwweighsw235lbs.wWhilewpreformingwawm
allampatiwassessment,wyouwnoticewherwsoftwpalatewandwmajorwpartwofwuvulawpresent.wYouwcouldwcl
assifywherwaswawclass:w-wCORRECTwANSWERSwII



StructureswseenwwithwClasswIwMallampatiwassessmentw-
wCORRECTwANSWERSwSoftwpalete,wuvula,wfauces,wpillarswvisible

,StructureswseenwwithwClasswIIwMallampatiwassessmentw-
wCORRECTwANSWERSwSoftwPalate,wmajorwpartwofwuvula,wfauceswvisible




StructureswseenwwithwClasswIIIwMallampatiwassessmentw-
wCORRECTwANSWERSwSoftwpalate,wbasewofwuvulawvisible




StructureswseenwwithwClasswIVwMallampatiwassessmentw-
wCORRECTwANSWERSwOnlywhardwpalatewvisible




Whatwcanwcausewawleftwshiftwinwthewoxyhemoglobinwdissociationwcurve?w

ARDS

Awpt.wwhowreceivedwmasswtransfusion

RespiratorywAcidosis

Sepsisw-wCORRECTwANSWERSwAwpatientwwhowreceivedwmasswtransfusion



Wouldwshiftwleftwduewtowincreasedwoxygenwcarrying.wARDS,wRespiratorywacidosis,wandwsepsiswallwar
ewassociatedwwithwacidosis,wlowerwpH,whigherwlevelswofwCO2,wwhichwwouldwcausewawrightwshift



WhenwitwcomeswtowmakingwATPwduringwaerobicwrespiration,wwhywiswoxygenwnecessary?w-
wCORRECTwANSWERSwOxygenwiswthewfinalwelectronwacceptorwinwthewelectronwtransportwchain




High-
energywelectronswgowthroughwthewelectronwtransportwchainwinwawserieswofwexe3rgonicwredoxwreact
ions.wUltimatelywusedwtowproducewATP.



Whichwofwthewfollowingwmethodswiswthewleastweffectivewwaywtowconfirmwendotrachealwtubewplace
ment?

,EndwTidalwCO2wcapnometry

Foggingwinwthewtube

Directwvisualizationwbetweenwthewvocalwcords

Bilateralwequalwlungwsoundsw-wCORRECTwANSWERSwFoggingwinwthewtube



Whatwiswthewgold-standardwtowconfirmwETTwplacement?w-
wCORRECTwANSWERSwEndwTidalwCO2wcapnometry




WhatwiswGraham'swlaw?w-
wCORRECTwANSWERSwGaswwillwdiffusewfromwhighwpressurewtowlowwpressure




HigherwO2wconcentrationwinwalveoliwwillwdiffusewtowcapillaries,wwhichwhaswlowerwconcentrationswo
fwO2



Acronymwtowconsiderwforwsurgicalwcricwconsiderationsw-wCORRECTwANSWERSwSMART

SurgerywofwNeck

Mass

Accesswtowthewneckw-wobesity,wLimitedwROM

Radiation

Tumor



Acronymwtowconsiderwwhenwpredictingwawdifficultwairwayw-wCORRECTwANSWERSwHEAVEN

Hypoxemia

Extremeswofwsizew-wobesewpt,wpetitewpt.w

Anatomicwdisruption/obstructionw

Vomit/blood/fluid

Exsanguination-wbledwoutwsowmuchwtheywcan'twkeepwSpO2wup

, Neckwmobility/neurowinjury



MallampatiwscorewvswCormack-Lenanewscorew-
wCORRECTwANSWERSwMallampatiwiswdirectwvisualizationwofwtheworalwcavitywandworopharynx



Cormack-Lenanewscorewiswdirectwvisualizationwofwthewpharynxwandwglottiswwithwlaryngoscope



Howwdownon-depolarizingwparalyticwagents,wlikewrocuronium,wwork?w-
wCORRECTwANSWERSwTheywcompetewwithwacetylcholine,wblockingwnicotinicwreceptors




Non-
depolarizingwneuromuscularwblockingwdrugswdownotwdepolarizewreceptions.wTheywcompetewwithw
Achwforwbindingwsiteswonwnicotinicwalphawsubunits,wcausingwskeletalwrelaxation



Youwpreparewtowintubatewawpediatricwpatientwexperiencingwseverewbronchospasm.wWhichwinducti
onwagentwwillwyouwutilize?w-wCORRECTwANSWERSwKetamine



Ketaminewiswthewinductionwagentwofwchoicewforwreactivewairwaywdiseasewduewtowitswsympathomim
eticwandwbronchodilatoryweffects.



Whichwiswthewshortestwactingwparalytic?w-wCORRECTwANSWERSwSuccinylcholine



Onwawscenewcallwwithwaw63wyearwoldwmalewpatient,wyouwelectwtowintubatewhimwafterwawfailedwtrialwo
fwBPAPwforwfluidwoverloadwandwrespiratorywfailure.wYourwpatientwhaswawhxwofwhypertension,wdiabet
es,wendwstagewrenalwdiseasewandwmissedwhiswlastw3wdialysiswappointments.wWhatwparalyticwwouldw
bewcontraindicatedwforwthiswpatient?w-wCORRECTwANSWERSwSuccinylcholine



Whichwneuromuscularwblockingwagentwiswclassifiedwaswdepolarizing?w-
wCORRECTwANSWERSwSuccinylcholine