Airway Skills & RSI

Question 1

High 5 Difficult Airway Indicators

Answer 1

Upper Airway Hemorrhage, Mandibular Fracture, Decreased Thyromental Distance, Direct Laryngeal Trauma, Expanding Neck Hematoma

Question 2

Which neuromuscular diseases are contraindications for Succinylcholine?

Answer 2

Guillian-Barre, ALS, Myasthenia Gravis, Muscular Dystrophy

Question 3

Succinylcholine contraindications?

Answer 3

Burns greater than 24 hours, spinal cord injury, neuromuscular disorders, dialysis, malignant hyperthermia

Question 4

ET Tube Confirmations

Answer 4

Visualize Tube through cords, chest rise and fall, negative epigastric sounds, bilateral breath sounds, tube depth, pilot cuff tension, fog in the tube, sp02, etc02

Question 5

Indications for RSI without Consult

Answer 5

GCS less than or equal to 8 with RR= 8 or >/= 35
OR
GCS less than or equal to 8 with SpO2 = 90 on NRB

Question 6

Lidocaine Dose for Adult RSI Pre-medication

Answer 6

1 mg/kg

Question 7

Adult Induction dose of Etomidate for RSI normotensive patient

Answer 7

0.3 mg/kg

Question 8

Adult Induction dose of Etomidate for hypotensive RSI patient

Answer 8

0.15 mg/kg

Question 9

Adult Induction dose of Versed for RSI

Answer 9

0.1 mg/kg

Question 10

Adult Induction dose of Ketamine for RSI

Answer 10

2 mg/kg

Question 11

Adult dose of Succinylcholine in RSI

Answer 11

1.5 mg/kg (Max 200mg)

Question 12

If Succinylcholine contraindicated, what is the Vecuronium dose for induction?

Answer 12

0.1 mg/kg

Question 13

Atropine dose pre-RSI for < than 8 y/o or less than 6.0 ETT?

Answer 13

0.02 mg/kg

Question 14

What ETCO2 would you try and target in a head-injured patient?

Answer 14

30 mmHg

Question 15

VDP Dose of Etomidate - Doses?

Answer 15

0.3 mg/kg for the first dose, and 2 further doses of 0.15 mg/kg

Question 16

VDP Dose of Ketamine - Doses?

Answer 16

2 mg/kg for the first dose, and 2 further doses of 1 mg/kg

Question 17

VDP Dose of Versed - Doses?

Answer 17

0.1 mg/kg to a max of 5 mg, but cannot be repeated without consult

Question 18

VDP - If significant resistance to ventilation continues despite adequate sedation AND ANALGESIA, the paramedic may administer what medication?

Answer 18

Vecuronium 0.05 mg/kg to a max dose of 10 mg.

Question 19

During VDP, can you treat the patient with Fentanyl in addition to the sedative you use?

Answer 19

Yes!! As long as the blood pressure is stable and there is no risk of hypotension, Fentanyl is a great medication to use in conjunction to your sedative of choice in order to ensure adequate post-intubation management.

Question 20

Under what age is a surgical cricothyroidotomy contraindicated in a pediatric patient?

Answer 20

8

Question 21

The “D” in DOPES stands for?

Answer 21

Displaced tube

Question 22

The “O” in DOPES stands for?

Answer 22

Obstruction

Question 23

The “P” in DOPES stands for?

Answer 23

Pneumothorax

Question 24

The “E” in DOPES stands for?

Answer 24

Equipment Malfunction

Question 25

The "S" in DOPES stands for?

Answer 25

Stacking Breaths

Question 26

If the EtCO2 is greater than 45, how would you change your vent settings?

Answer 26

Increase respiratory rate in increments of 2.

Question 27

If the EtCO2 is less than 35, how would you change your vent settings?

Answer 27

Decrease respiratory rate in increments of 2.

Question 28

In standard ventilator settings, how many mL/kg do we start ventilating the patient with?

Answer 28

8 ml/kg IBW

Question 29

At what age can you place a pediatric patient on CPAP?

Answer 29

13 or older

Question 30

What are contraindications for a Nasal Intubation?

Answer 30

Patients on blood thinners, Patient with upper airway hemorrhage or significant facial trauma, patient with evidence of a basilar skull fracture.

Question 31

What site would you decompress with a needle thoracostomy on an adult patient over the age of 15?

Answer 31

5th intercostal space anterior axillary line

Question 32

If unable to perform a needle thoracostomy at the 5th intercostal space, which site would you use?

Answer 32

2nd intercostal space at the mid-clavicular line

Question 33

What site would you perform a needle thoracostomy on a child under the age of 15?

Answer 33

2nd intercostal space at the mid-clavicular line

Question 34

What is the formula for ETT size in pediatric patients?

Answer 34

16 + the child's age divided by 4

Question 35

What is the normal ETT Tube depth for a male adult patient?

Answer 35

21-23 cm

Question 36

What is the normal ETT Tube depth for a female adult patient?

Answer 36

20-22cm

Question 37

What is the normal Nasal Tube depth for an adult patient?

Answer 37

25-28cm