Airway

Question 1

What is the ‘A’ in the MARCH algorithm?

Answer 1

Airway.

Question 2

What is the goal of airway management in TCCC?

Answer 2

Ensure a patent airway for adequate oxygenation and ventilation.

Question 3

What is the first step in assessing the airway in Tactical Field Care?

Answer 3

Check for responsiveness and airway patency.

Question 4

What maneuver is used to open the airway in an unconscious casualty without suspected spinal injury?

Answer 4

Head tilt-chin lift.

Question 5

What maneuver is preferred to open the airway in suspected spinal trauma?

Answer 5

Jaw thrust.

Question 6

What simple adjunct is often used to maintain airway patency in an unconscious casualty?

Answer 6

Nasopharyngeal airway (NPA).

Question 7

What is a contraindication to NPA use?

Answer 7

Basilar skull fracture.

Question 8

What is a sign of airway obstruction?

Answer 8

Stridor, gurgling, use of accessory muscles, or no air movement.

Question 9

What airway intervention should be considered if the NPA fails to maintain airway patency?

Answer 9

Surgical cricothyroidotomy.

Question 10

What are the indications for surgical cricothyroidotomy in TCCC?

Answer 10

Severe facial trauma or airway obstruction where less invasive methods fail.

Question 11

What is the preferred device for surgical cricothyroidotomy in TCCC?

Answer 11

Bougie-aided open surgical technique.

Question 12

What landmark is used for cricothyroidotomy?

Answer 12

Cricothyroid membrane between the thyroid and cricoid cartilage.

Question 13

What is the minimum equipment needed for cricothyroidotomy?

Answer 13

Scalpel, tracheostomy hook or forceps, bougie, and endotracheal tube or trach tube.

Question 14

What size tube is typically used for cricothyroidotomy?

Answer 14

5.5-6.0 mm internal diameter cuffed tube.

Question 15

How should correct placement of cricothyroidotomy tube be confirmed?

Answer 15

Chest rise, breath sounds, CO2 detection (if available).

Question 16

What is the TCCC-recommended airway for unconscious trauma casualties?

Answer 16

Nasopharyngeal airway (NPA).

Question 17

What is the airway priority in care under fire?

Answer 17

Airway management is deferred unless absolutely necessary.

Question 18

What airway technique can be performed rapidly under tactical conditions if necessary?

Answer 18

Recovery position or NPA insertion.

Question 19

Why is cricothyroidotomy preferred over endotracheal intubation in tactical settings?

Answer 19

It is quicker, requires less equipment, and is more reliable in austere environments.

Question 20

What is the common complication of NPA insertion?

Answer 20

Epistaxis (nosebleed).

Question 21

What should be done if NPA is dislodged?

Answer 21

Reinsert or replace it.

Question 22

What position helps maintain airway in unconscious breathing casualties?

Answer 22

Recovery position (lateral recumbent).

Question 23

What is the most reliable method to secure a surgical airway in a field setting?

Answer 23

Open surgical cricothyroidotomy.

Question 24

What is an indicator of successful airway management?

Answer 24

Adequate chest rise and absence of distress.

Question 25

What device is not typically used for airway management in TCCC due to complexity?

Answer 25

Endotracheal intubation with laryngoscopy.

Question 26

When is airway management delayed in TCCC?

Answer 26

During care under fire phase.

Question 27

What should always be monitored after airway intervention?

Answer 27

Airway patency and breathing effectiveness.

Question 28

What is the advantage of the NPA over an oropharyngeal airway in TCCC?

Answer 28

Can be used in conscious or semi-conscious patients.

Question 29

What type of casualty may not tolerate an oropharyngeal airway?

Answer 29

Semi-conscious or conscious casualty.

Question 30

Why is the recovery position helpful?

Answer 30

It helps prevent airway obstruction in unconscious casualties.

Question 31

What should be avoided in facial trauma with airway obstruction?

Answer 31

Blind insertion of NPAs or OPAs.

Question 32

What technique improves surgical airway success?

Answer 32

Using a bougie to guide the tube.

Question 33

What is a potential complication of cricothyroidotomy?

Answer 33

Bleeding, false passage, or subcutaneous emphysema.

Question 34

How often should the airway be reassessed in tactical care?

Answer 34

Continuously, especially during movement or transport.

Question 35

What does the absence of breath sounds after airway placement suggest?

Answer 35

Incorrect placement or obstruction.

Question 36

What color change in a CO2 detector confirms airway placement?

Answer 36

Color change from purple to yellow (if device used).

Question 37

What is the most likely cause of sudden airway obstruction in the unconscious casualty?

Answer 37

Tongue obstruction.

Question 38

Why is airway management more challenging in tactical environments?

Answer 38

Limited equipment, lighting, space, and ongoing threat.

Question 39

What size NPA is commonly used in adults?

Answer 39

28-34 French.

Question 40

What is the ideal lubrication for NPA insertion?

Answer 40

Water-based lubricant.

Question 41

How should an NPA be inserted?

Answer 41

Bevel toward the septum, gently following the floor of the nose.

Question 42

What is a sign that a cricothyroidotomy has failed?

Answer 42

No chest rise or air movement after tube placement.

Question 43

What can be done if the cricothyroidotomy tube becomes dislodged?

Answer 43

Reinsert or re-establish the airway.

Question 44

Why is rapid airway control essential in trauma?

Answer 44

To prevent hypoxia and death.

Question 45

What are signs of inadequate ventilation?

Answer 45

Cyanosis, confusion, low oxygen saturation, tachypnea.

Question 46

What adjunct may be used to support breathing if the airway is open?

Answer 46

Bag-valve mask (if trained and available).

Question 47

What should always accompany cricothyroidotomy?

Answer 47

Ventilation support and continuous monitoring.

Question 48

What action is taken if airway sounds are abnormal post airway insertion?

Answer 48

Reassess placement and consider obstruction or dislodgement.

Question 49

What is the tactical priority after establishing an airway?

Answer 49

Move to the next step in MARCH: Respiration.