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
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
