Airway Management I

Question 1

The upper airways or upper respiratory tract includes the nose and nasal passages, paranasal sinuses, the pharynx, and the portion of the larynx above the ___. The lower airways or lower respiratory tract includes the portion of the larynx below the _(same)_, trachea, bronchi and bronchioles.

Answer 1

1. Vocal cords;

Note: The TCC Paramedic School curriculum emphasised the glottis as the division point between the upper and lower airways.

https://en.wikipedia.org/wiki/Respiratory_tract

Question 2

Approximately ___% of the population has no gag reflex at baseline.

Answer 2

1. 30;

Major Memory System: Male homos (30) engage in oral sex without exhibiting a gag reflex.

Manual of Emergency Airway Management, 3rd Ed.

Question 3

___ refers to injuries caused by increased air or water pressure, such as during airplane flights or scuba diving.

Answer 3

1. Barotrauma;

Note: Barotrauma of the inner ear is common. Generalized barotraumas, including decompression sickness, affect the entire body.

https://www.health.harvard.edu/a_to_z/barotrauma-a-to-z

Question 4

What is the name of the air reservoir to which a syringe is connected in order to inflate an endotracheal tube cuff?

Answer 4

1. Pilot balloon;

https://www.medscape.com/answers/865068-32798/what-is-the-role-of-the-pilot-balloon-on-a-cuffed-tracheostomy-tube

Question 5

“There aren’t Mac or Miller paramedics, there are Mac or Miller ___.”

Answer 5

1. Patients;

Missy, TCC Paramedic School Adjunct Professor

Question 6

The ___ cartilage is a ring of _(cartilage type)_ cartilage located at the inferior aspect of the ___ and is the only complete ring of cartilage around the trachea.

Answer 6

1. Cricoid;
2. Hyaline;
3. Larynx;
   * https://emedicine.medscape.com/article/1949369-overview*

Question 7

What does the acronym NO DESAT stand for?

Answer 7

NO DESAT

N - Nasal

O - Oxygen

D - During

E - Efforts

S - Securing a

T - Tube

https://epmonthly.com/article/no-desat/

Question 8

The ___ is a small pointed eminence of the external ear, situated in front of the concha, and projecting backward over the meatus.

Answer 8

1. Tragus;

https://en.wikipedia.org/wiki/Tragus_(ear)

Question 9

Colorimetric capnometers turn from _(color)_ to _(color)_ when carbon dioxide is introduced.

Answer 9

1. Purple;
2. Yellow;

Note: Purple = Problem, Gold = Golden;

https://www.medtronic.com/covidien/en-us/products/intubation/nellcor-adult-pediatric-colorimetric-co2-detector.html

Question 10

The ___ reflex is of no clinical value when assessing the need for intubation, and in fact may be dangerous to assess. Evaluation of spontaneous or volitional ___ is a better assessment of a patient’s ability to protect their airway.

Answer 10

1. Gag;
2. Swallowing;
   * Manual of Emergency Airway Management, 5th Ed.*

Question 11

The decision to intubate should be based on three fundamental clinical assessments:

1. ___
2. ___
3. ___

Answer 11

1. Is there a failure of airway maintenance or protection?
2. Is there a failure of ventilation or oxygenation?
3. What is the anticipated clinical course?
   * Manual of Emergency Airway Management, 5th Ed.*

Question 12

The presence of pooled ___ in a patient’s ___ should be considered to indicate a potential failure of airway protection.

Answer 12

1. Secretions;
2. Oropharynx;
   * Manual of Emergency Airway Management, 3rd Ed.*

Question 13

Unless ventilatory or oxygenation failure is due to a ___ cause, such as narcotic overdose, ___ is required.

Answer 13

1. Reversible;
2. Intubation;
   * Manual of Emergency Airway Management, 3rd Ed.*

Question 14

When evaluating a patient for emergency airway management, the first assessment should be of the ___ and ___ of the airway. In many cases, these can be superficially confirmed by simpy having the patient ___.

Answer 14

1. Patency;
2. Adequacy;
3. Speak (Ask questions such as “What is your name?”);
   * Manual of Emergency Airway Management, 3rd Ed.*

Question 15

Intermittent expiratory moaning, often exhibited by patients in pain.

Answer 15

1. Hysterical (or psychogenic) stridor;

Manual of Emergency Airway Management, 3rd Ed.

Question 16

If spinal cord injury has impaired intercostal muscle functioning, ___ breathing may be present. In this form of breathing, there is little movement of the ___, and inspiration is evidenced by an apparent increase in ___ volume.

Answer 16

1. Diaphragmatic;
2. Chest wall;
3. Abdominal;
   * Manual of Emergency Airway Management, 3rd Ed.*

Question 17

A medical term meaning “naturally accompanying or associated with.”

Answer 17

1. Concomitant;

Google Dictionary

Question 18

If doubt exists as to whether a patient requires intubation, err on the side of ___.

Answer 18

1. Intubating the patient;

Manual of Emergency Airway Management, 3rd Ed.

Question 19

The gag reflex is not involved in ___ closure or protection of the ___.

Answer 19

1. Laryngeal;
2. Airway;
   * Manual of Emergency Airway Management, 3rd Ed.*

Question 20

The ability of a patient to ___ with a ___, unobstructed voice is strong evidence of airway patency, protection, and ___ perfusion.

Answer 20

1. Phonate;
2. Clear;
3. Cerebral;
   * Manual of Emergency Airway Management, 5th Ed.*

Question 21

Although an oropharyngeal or nasopharyngeal airway may restore airway patency in a severly ill or injured patient, they do not provide any protection against ___.

Answer 21

1. Aspiration;

Manual of Emergency Airway Management, 5th Ed.

Question 22

Patients who are unable to maintain their own airway are also unable to ___ it. Therefore, as a general rule, any patient who requires the establishment of a patent airway also requires ___ of that airway.

Answer 22

1. Protect;
2. Protection;

Note: The exception is when a patient has an immediately reversible cause of airway compromise.

Manual of Emergency Airway Management, 5th Ed.

Question 23

The finding of pooled ___ in a patient’s ___ indicates a potential failure of airway protective mechanisms, and hence a failure of airway ___.

Answer 23

1. Secretions;
2. Posterior oropharynx;
3. Protection;
   * Manual of Emergency Airway Management, 5th Ed.*

Question 24

If a patient is unable to ___ sufficiently, or if adequate ___ cannot be achieved despite the use of supplemental oxygen, then intubation is indicated.

Answer 24

1. Ventilate;
2. Oxygenation;
   * Manual of Emergency Airway Management, 5th Ed.*

Question 25

Unless ventilatory or oxygenation failure is resulting from a rapidly ___ cause, such as ___ overdose, or a condition known to be successfully managed with noninvasive ventilation (e.g., Bi-PAP for acute pulmonary edema), intubation is required.

Answer 25

1. Reversible; 2. Opioid; * Manual of Emergency Airway Management, 5th Ed.*

Question 26

In many cases, the adequacy of an airway is confirmed by simply having the patient \_\_\_. A ___ voice (as opposed to a muffled or distorted voice), the ability to ___ and ___ in the modulated manner required for speech, and the ability to comprehend the question and follow instruction are strong evidence of adequate ___ function.

Answer 26

1. Speak; 2. Normal; 3. Inhale; 4. Exhale; 5. Upper airway; * Manual of Emergency Airway Management, 5th Ed.*

Question 27

When evaluating a patient for emergency airway management, after assessing verbal response to questions, conduct examinations of the \_(five structures)\_.

Answer 27

1. Mouth; 2. Oropharynx; 3. Mandible; 4. (Central) Face; 5. (Anterior) Neck (including the larynx and trachea); * Manual of Emergency Airway Management, 5th Ed.*

Question 28

Name four key signs of upper airway obstruction.

Answer 28

1. Muffled or "hot potato" voice (as though the patient is speaking with a mouthful of hot food); 2. Inability to swallow secretions, because of either pain or obstruction; 3. Stridor; 4. Dyspnea; * Manual of Emergency Airway Management, 5th Ed.*

Question 29

When assessing a patient's neck for emergency airway management, move the ___ from side to side, asessing for \_\_\_, indicating normal contact of the airway with the air-filled upper esophagus. Absence of this sign may be caused by ___ between the \_(same as #1)\_ and the upper esophagus.

Answer 29

1. Larynx; 2. Laryngeal crepitus; 3. Edema; * Manual of Emergency Airway Management, 5th Ed.*

Question 30

The presence of ___ stridor, however slight, indicates some degree of upper airway obstruction. Lower airway obstruction, occurring beyond the level of the \_\_\_, more often produces ___ stridor.

Answer 30

1. Inspiratory; 2. Glottis; 3. Expiratory; * Manual of Emergency Airway Management, 5th Ed.*

Question 31

When evaluating a patient for possible emergency airway management, note their respiratory pattern, observing the chest through ___ respiratory cycles, looking for normal, symmetrical, concordant chest movement. Ausculate the chest for adequacy of air \_\_\_. Decreased breath sounds indicate \_(name two of four listed)\_ or other disease pathology.

Answer 31

1. Several; 2. Exchange; 3. Pneumothorax, hemothorax, pleural effusion, emphysema; * Manual of Emergency Airway Management, 5th Ed.*

Question 32

1. What are the five general steps for evaluating the *patency and adequacy* of a patient's airway when considering the necessity of emergency airway management?

Answer 32

1. Assess verbal response to questions (and ability to swallow); 2. Assess the upper airway (mouth, oropharynx, mandible, central face, anterior neck); 3. Assess ventilation (chest wall movement, lung sounds, respiratory pattern); 4. Assess oxygenation (SpO₂, PetCO2, [CO]); 5. Consider the anticipated clinical course; * Manual of Emergency Airway Management, 5th Ed.*

Question 33

\_\_\_ stridor, when seen in \_\_\_, is particularly ominous and typically mandates intubation.

Answer 33

1. Inspiratory; 2. Adults; * Manual of Emergency Airway Management, 5th Ed.*

Question 34

Although there is no absolute cutoff for oxygen saturation or EtCO₂ that dictates intubation, a saturation that cannot be sustained above \_\_\_%, a RR \> ___ or a CO₂ \> ___ mm Hg has strong associations with intubation.

Answer 34

1. 80; 2. 30; 3. 100; Major Memory System: The **Messiah** (30) intubates Amy Quist with a bottle of **hot sauce** (100) that has a burning **fuse** (80) protruding from the top. *Manual of Emergency Airway Management, 5th Ed.*

Question 35

\_(respiratory disease)\_ and \_(respiratory disease)\_ are uncommon causes of ED intubation and can typically be managed with medical therapy and noninvasive postive airway pressure.

Answer 35

1. COPD; 2. Acute pulmonary edema; * Manual of Emergency Airway Management, 5th Ed.*

Question 36

One can benefit from thinking about airway difficulty in two categories; a(n) ___ difficult airway and a(n) ___ difficult airway.

Answer 36

1. Anatomically; 2. Physiologically; * Manual of Emergency Airway Management, 5th Ed.*

Question 37

Depending on the degree of predicted difficulty, one should not administer a ___ medication to a patient unless one has a measure of confidence that gas exchange can be maintained if laryngoscopy and intubation fail. Accordingly, if an anatomically difficult airway is identified, the ___ Algorithm should be used.

Answer 37

1. Neuromuscular blocking (paralytic); 2. Difficult Airway; * Manual of Emergency Airway Management, 5th Ed.*

Question 38

Difficult direct laryngoscopy, defined as a grade ___ or grade ___ \_\_\_ view, occurs in approximately \_\_\_% of all adult *emergency* intubations.

Answer 38

1. III; 2. IV; 3. Laryngoscopic (Cormack-Lehane); 4. 10; Major Memory System: **Amy** (III) Quist lies naked on the operating room table with **hairy** (IV) nipples, looking **hideous** (10). *Manual of Emergency Airway Management, 5th Ed.*

Question 39

Based on large registry data of adult intubations, rescue surgical airways occur in \_\_\_-\_\_\_% of all encounters.

Answer 39

1. 0.3-0.5; Major Memory System: A **sumo** (0.3) wrestler performs a cricothyrotomy on a **weasel** (0.5). *Manual of Emergency Airway Management, 5th Ed.*

Question 40

In clinical practice, the difficult airway has four dimensions: 1. Difficult \_\_\_ 2. Difficult \_\_\_ 3. Difficult \_\_\_ 4. Difficult \_\_\_

Answer 40

1. Laryngoscopy; 2. BMV; 3. EGD; 4. Cricothyrotomy; * Manual of Emergency Airway Management, 5th Ed.*

Question 41

With the exception of \_(situation)\_ or \_(situation)\_, it is rare for VL to yield a Cormack-Lehane grade III (or worse) glottic view.

Answer 41

1. Severely reduced mouth opening such that the device is unable to be inserted; 2. Sudden unanticipated device failure; * Manual of Emergency Airway Management, 5th Ed.*

Question 42

Cormack-Lehane grade III view.

Answer 42

1. Only visible glottic structure is the epiglottis; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 43

Cormack-Lehane grade IV view.

Answer 43

1. No glottic structures visible; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 44

Cormack-Lehane grade I view.

Answer 44

1. Virtually the entire glottic aperture is visible, including the arytenoids, vocal cords and epiglottis; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 45

Cormack-Lehane grade II view.

Answer 45

1. Posterior portion of the vocal cords and/or arytenoids, as well as epiglottis, visible; Note: IIa view - Some portion of the cords is visible; IIb view - No portion of the cords is visible; *Manual of Emergency Airway Management, 5th Ed.*

Question 46

What acronym is useful in helping a paramedic answer the question, "Does this patient's airway warrant using the Difficult Airway Algorithm, or is it appropriate and safe to proceed directly to RSI?"

Answer 46

1. LEMONS; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 47

What does LEMONS stand for, with respect to evaluating for a difficult airway?

Answer 47

**LEMONS** ## Footnote **L - L**ook externally (gestalt) **E - E**valuate 3-3-2 **M - M**allampati score **O - O**bstruction/Obesity **N - N**eck mobility **S - S**ituation *Manual of Emergency Airway Management, 5th Ed.*

Question 48

An organized whole that is perceived as more than the sum of its parts.

Answer 48

1. Gestalt; ## Footnote *Google Search*

Question 49

The "L" in the LEMONS acronym serves as a reminder for the airway practitioner to look at their patient broadly and to simply form their own ___ about the possiblity of difficult intubation.

Answer 49

1. Gestalt; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 50

The 3-3-2 evaluation is derived from the studies of the geometrical requirements for successful DL, that is, the ability of the operator to create a direct line of sight from outside the ___ to the \_\_\_.

Answer 50

1. Mouth; 2. Glottis; Note: It is not known whether this rule has any value in predicting difficult VL. *Manual of Emergency Airway Management, 5th Ed.*

Question 51

A normal patient can open his or her mouth sufficiently to accommodate ___ of his or her own fingers between the upper and lower \_\_\_.

Answer 51

1. 3; 2. Incisors; * Manual of Emergency Airway Management, 5th Ed.*

Question 52

The second "three" of the 3-3-2 Rule evaluates the length of the ___ space by ensuring the patient's ability to accommodate three of his or her own fingers between the tip of the ___ and the \_\_\_.

Answer 52

1. Mandibular; 2. Mentum; 3. Hyoid Bone; * Manual of Emergency Airway Management, 5th Ed.*

Question 53

In the 3-3-2 Rule, the first "3" assesses the adequacy of ___ access, while the second three addresses the dimensions of the ___ space to accommodate the ___ on DL.

Answer 53

1. Oral; 2. Mandibular; 3. Tongue; * Manual of Emergency Airway Management, 5th Ed.*

Question 54

The final "2" of the 3-3-2 Rule identifies the location of the ___ in relation to the base of the \_\_\_.

Answer 54

1. Larynx; 2. Tongue; * Manual of Emergency Airway Management, 5th Ed.*

Question 55

Name the structures visible in a class I Mallampati view.

Answer 55

1. Hard palate; 2. Soft palate; 3. Uvula; 4. Fauces; 5. Pillars (AKA pillars of the fauces); * Manual of Emergency Airway Management, 5th Ed.*

Question 56

Name the structures visible in a class II Mallampati view.

Answer 56

1. Hard palate; 2. Soft palate; 3. Uvula; 4. Fauces; * Manual of Emergency Airway Management, 5th Ed.*

Question 57

Name the structures visible in a class III Mallampati view.

Answer 57

1. Hard palate; 2. Soft palate; 3. Base of uvula; * Manual of Emergency Airway Management, 5th Ed.*

Question 58

Name the structures visible in a class IV Mallampati view.

Answer 58

1. Hard palate; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 59

The presence of stridor is generally considered to indicate the airway has been reduced to less than \_\_\_% of its normal caliber, or to a diameter of ___ mm or less.

Answer 59

1. 50; 2. 4.5 mm; Major Memory System: Amy Quist **howls** (50) stridorously while getting an **ariola** (4.5) pierced. *Manual of Emergency Airway Management, 5th Ed.*

Question 60

Obesity, in itself, ___ be considered to portend difficult laryngoscopy.

Answer 60

1. Should; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 61

What mnemonic is useful in identifying the possibility of difficult BMV?

Answer 61

1. ROMAN; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 62

What does ROMAN stand for, with respect to BMV?

Answer 62

**ROMAN** ## Footnote **R - R**adiation / Restriction **O - O**besity / **O**bstruction / **O**bstructive Sleep Apnea **M - M**ask Seal / **M**allampati / **M**ale Sex **A - A**ge (\> 55) **N - N**o teeth *Manual of Emergency Airway Management, 5th Ed.*

Question 63

Recent evidence suggests that ___ treatment ot the neck is one of the strongest predictors of difficult and failed mask ventilation.

Answer 63

1. Radiation; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 64

To what does the "restriction" component of the ROMAN mnemonic refer?

Answer 64

1. Patients whose lungs and thoraces are resistant to ventilation and require high ventilation pressures; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 65

Age older than ___ years is associated with a higher risk of difficult BMV, perhaps because of a loss of muscle and tissue tone in the upper airway.

Answer 65

1. 55; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 66

\_\_\_ gender is a predictor of difficult BMV.

Answer 66

1. Male; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 67

A medical term meaning "lacking teeth."

Answer 67

1. Edentulous; ## Footnote *Google Dictionary*

Question 68

Consider leaving dentures in situ for \_(airway intervention)\_ and removing them for \_(airway intervention)\_.

Answer 68

1. BMV; 2. Intubation; * Manual of Emergency Airway Management, 5th Ed.*

Question 69

Factors that predict difficulty in placing an EGD and providing adequate gas exchange can be recalled using the acronym \_\_\_.

Answer 69

1. RODS; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 70

What does RODS stand for, with respect to EGD placement?

Answer 70

**RODS** ## Footnote **R - R**estriction **O - O**bstruction / **O**besity **D - D**isrupted / **D**istorted Airway Anatomy **S - S**hort Thyromental Distance *Manual of Emergency Airway Management, 5th Ed.*

Question 71

According to the Manual of Emergency Airway Management, it is generally best to attempt EGD ventilation with a patient's torso elevated ___ degrees, or in the reverse ___ position.

Answer 71

1. 30; 2. Trendelenburg; * Manual of Emergency Airway Management, 5th Ed.*

Question 72

A small mandibular space, as assessed by a patient's ___ distance, may indicate that the tongue resides less in the mandibular fossa and more in the oral cavity; this can obstruct and complicate EGD insertion.

Answer 72

1. Thyromental; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 73

What mnemonic is useful in assessing for the possiblity of a difficult cricothyrotomy?

Answer 73

1. SMART; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 74

What does SMART stand for, with respect to difficuylt cricothyrotomy?

Answer 74

**SMART** ## Footnote **S - S**urgery (recent or remote) **M - M**ass **A - A**ccess / **A**natomy **R - R**adiation (and other deformity or scarring) **T - T**umor *Manual of Emergency Airway Management, 5th Ed.*

Question 75

A medical term for "double chin."

Answer 75

1. Overyling mandibular pannus; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 76

When intubation is indicated, the first question to ask is, "\_\_\_?" If the answer is "no," the next question should be, "\_\_\_?" With what four mnemonics can this question be answered?

Answer 76

1. Is this a Crash Airway? 2. Is this airway difficult? 3. LEMONS; 4. ROMAN; 5. RODS; 6. SMART; * Manual of Emergency Airway Management, 5th Ed.*

Question 77

If LEMONS and ROMAN are assessed first, in order, then each component of RODS also has been assessed, with the exception of the \_\_\_.

Answer 77

1. D (distorted anatomy); ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 78

The LEMONS assessment is most helpful when completely ___ and indicates that nearly all patients would be candidates for RSI if truly LEMON-\_\_\_.

Answer 78

1. Normal; 2. Negative; * Manual of Emergency Airway Management, 5th Ed.*

Question 79

The only two studies to compare obese and lean patients head to head found a \_\_\_-fold increase in intubation difficulty for obese patients.

Answer 79

1. Five (15% vs. about 3% of lean patients); Major Memory System: Amy Quist, notably obese, lies on the operating room table with a slimy black **eel** (5) squirming around on her enormous belly. *Manual of Emergency Airway Management, 5th Ed.*

Question 80

Mallampati is not nearly as important for video laryngoscopy as for direct laryngoscopy, because the video viewer on most video laryngoscopes is postioned beyond the \_\_\_, thus eliminating it from consideration.

Answer 80

1. Tongue; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 81

If a patient is unconscious, near death, with agonal or no respirations, and expected to be unresponsive to the stimulation of laryngoscopy, into which Emergency Airway Algorithm do they fall?

Answer 81

1. Crash Airway Algorithm; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 82

If neither a Crash Airway Algorithm nor a Difficult Airway Algorithm are appropriate for a patient requiring intubation, proceed with \_\_\_.

Answer 82

1. RSI (the Main Airway Algorithm); ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 83

Regardless of the Emergency Airway Algorithm used initially (Main [RSI], Crash, Difficult or EMS Difficult), if airway failure occurs, the ___ is immediately invoked.

Answer 83

1. Failed Airway Algorithm; ## Footnote *Manual of Emergency Airway Management, 5th Ed.*

Question 84

What method does Dr. Jarvis recommended for holding the King Vision™ video laryngoscope?

Answer 84

1. "Low and light" (i.e. At the base, right where the channel joins the blade, very lightly, in the left hand); Note: This technique prevents loss of the video signal from screen dislodgement, as well as prevents the laryngoscope from being inserted too deeply. *King Vision Intubation the Wilco Way https://www.youtube.com/watch?v=qhB7L0tknXI*

Question 85

What constitutes "The View" described by Dr. Jarvis as desirable during video laryngoscopy with the King Vision™?

Answer 85

1. "Full, midline epiglottis" (the top part of the screen should contain a view of the tip of the blade, placed into the vallecula); ## Footnote *King Vision Intubation the Wilco Way: https://www.youtube.com/watch?v=qhB7L0tknXI*

Question 86

What is the proper position for an ET tube to be situated in the King Vision™ video laryngoscope, according to Dr. Jarvis?

Answer 86

1. Place the tip of the tube at the end of the channel, but not past it; ## Footnote *King Vision Intubation the Wilco Way: https://www.youtube.com/watch?v=qhB7L0tknXI*

Question 87

What technique does Dr. Jarvis recommended for inserting the King Vision™ video laryngoscope?

Answer 87

1. Insert midline (hold the tongue with your fingers if needed; do not sweep the tongue with the laryngoscope) until the thumb touches the patient's lips and "The View" is obtained ; ## Footnote *King Vision Intubation the Wilco Way: https://www.youtube.com/watch?v=qhB7L0tknXI*

Question 88

What does Dr. Jarvis require immediately prior to, and during, video-assisted intubation?

Answer 88

1. Suctioning; ## Footnote *King Vision Intubation the Wilco Way: https://www.youtube.com/watch?v=qhB7L0tknXI*

Question 89

What modification does Dr. Jarvis recommend making to a Yankaur tip prior to suctioning the airway of a patient to be intubated?

Answer 89

1. Tape the carburator closed; ## Footnote *EMSTalks Safer Intubation with Dr. Jarvis: https://www.youtube.com/watch?v=xRAK5BthTvQ*

Question 90

When suctioning prior to intubation, keep the tip of the suction catheter ___ to the tip of the King Vision™ video laryngoscope.

Answer 90

1. Distal; ## Footnote *EMSTalks Safer Intubation with Dr. Jarvis: https://www.youtube.com/watch?v=xRAK5BthTvQ*

Question 91

What type of stylete does Dr. Jarvis recommend for use with the King Vision™ video laryngoscope? Under what circumstances should it be pushed beyond the tip of the ET tube?

Answer 91

1. Bougie; 2. In the event that the tube itself cannot be pushed past the cords; * EMSTalks Safer Intubation with Dr. Jarvis: https://www.youtube.com/watch?v=xRAK5BthTvQ*

Question 92

According to Dr. Jarvis, all DSI patients should be sat up at least ___ degrees, and placed in the ___ position.

Answer 92

1. 15; 2. Ears-to-sternal notch; Note: Dr. Jarvis recommends against attempting DSI while a patient is lying flat. My personal thought is that while other sources indicate VL has not been shown to benefit from this position (versus supine / neutral), in the event VL is unsuccessful, it is advantageous to have the patient already in the best position for DL as Plan B. *How to DSI (Delayed Sequence Intubation): https://www.youtube.com/watch?v=smzLCG2lRzY*

Question 93

What tube sizes does the standard King Vision aBlade Video Laryngoscope accomodate?

Answer 93

1. 6.0-8.0; ## Footnote *www.ambu.com*

Question 94

For what age range is the King Vision aBlade Video Laryngoscope with 3C standard blade rated?

Answer 94

1. 5+ y/o; Note: PediStat indicates a generic 5-year-zero-month-old warrants a 5.5 uncuffed ETT, while a 6-year-zer-month-old warrants a 6.0. *www.ambu.com*

Question 95

There are three types of cartilage: \_\_\_ - most common, found in the ribs, nose, larynx, trachea; a precursor of bone. \_\_\_ - found in invertebral discs, joint capsules, ligaments. \_\_\_ - found in the external ear, epiglottis and larynx.

Answer 95

1. Hyaline; 2. Fibro; 3. Elastic; * https://www.histology.leeds.ac.uk/bone/cartilage\_types.php*

Question 96

From a posterior view, the arytenoid cartilage is located inferior to the ___ and ___ cartilages, and superiorly to the ___ cartilage.

Answer 96

1. Corniculate; 2. Cuneiform; 3. Cricoid; * https://en.wikipedia.org/wiki/Arytenoid\_cartilage#/media/File:Gray955.png*

Question 97

The narrow passage between the pharynx and the base of the tongue; the opening at the back of the mouth into the throat.

Answer 97

1. Fauces; ## Footnote *https://en.wikipedia.org/wiki/Fauces\_(throat)*

Question 98

When a LEMONS assessment fails to show a problem, difficult intubation may occur only in as few as \_\_\_% of patients.

Answer 98

1. 2; Major Memory System: Danny Trejo (famous Mexican actor) squeezes an intact lemon into his mouth and is surprised to notice that the end looks just like an **ano** (2). *Manual of Emergency Airway Management, 5th Ed.*

Question 99

A term for wheezes heard during CHF exacerbation / pulmonary edema.

Answer 99

1. Cardiac asthma; ## Footnote *FireRescue1 Academy: CHF Vs. COPD, As Presented in November 2019*

Question 100

What is the most common cause of COPD.

Answer 100

1. Smoking; ## Footnote *FireRescue1 Academy: CHF Vs. COPD, As Presented in November 2019*