Cric, Chest Drain And Ventilation

Question 1

What is the primary goal of mechanical ventilation?

Answer 1

Ensure adequate oxygenation and ventilation.

Question 2

When is mechanical ventilation indicated in trauma?

Answer 2

Severe TBI, respiratory failure, or post-cricothyroidotomy.

Question 3

What is tidal volume?

Answer 3

The volume of air delivered per breath (usually 6–8 mL/kg).

Question 4

What is the recommended respiratory rate for adult trauma patients on a ventilator?

Answer 4

12–20 breaths per minute.

Question 5

What does PEEP stand for?

Answer 5

Positive End-Expiratory Pressure.

Question 6

Why is PEEP used in ventilators?

Answer 6

To keep alveoli open and improve oxygenation.

Question 7

What is a common starting PEEP value?

Answer 7

5 cm H2O.

Question 8

What mode is typically used for initial ventilator settings?

Answer 8

Assist-Control or Volume Control.

Question 9

What does a high peak inspiratory pressure indicate?

Answer 9

Airway obstruction or reduced lung compliance.

Question 10

What is the purpose of capnography in ventilated patients?

Answer 10

Monitor end-tidal CO2 for adequate ventilation.

Question 11

What is the primary indication for chest tube placement?

Answer 11

Tension pneumothorax, hemothorax, or large pneumothorax.

Question 12

What is the standard insertion site for a chest tube?

Answer 12

5th intercostal space, anterior to mid-axillary line.

Question 13

What size chest tube is recommended for trauma?

Answer 13

36–40 French for hemothorax.

Question 14

What is the purpose of a Heimlich valve or flutter valve?

Answer 14

Allow air to escape the pleural space without re-entry.

Question 15

How should a chest tube be secured?

Answer 15

Sutured in place and taped securely.

Question 16

What should you always do after chest tube insertion?

Answer 16

Obtain a chest X-ray if available; monitor for improvement.

Question 17

What are signs of chest tube malfunction?

Answer 17

No drainage, air leak, or increasing respiratory distress.

Question 18

What is the purpose of a water seal or drainage system?

Answer 18

Prevent air from returning to the chest cavity.

Question 19

What should be done if the chest tube is dislodged?

Answer 19

Seal with occlusive dressing and reassess immediately.

Question 20

What is a cricothyroidotomy?

Answer 20

A surgical airway procedure through the cricothyroid membrane.

Question 21

When is cricothyroidotomy indicated?

Answer 21

Cannot intubate, cannot oxygenate scenario.

Question 22

What is the landmark for cricothyroidotomy?

Answer 22

Between the thyroid cartilage and cricoid cartilage.

Question 23

What size tube is used in a surgical cricothyroidotomy?

Answer 23

5.5–6.0 mm internal diameter endotracheal or trach tube.

Question 24

What equipment is used in an open cricothyroidotomy?

Answer 24

Scalpel, bougie, tracheostomy tube, and forceps.

Question 25

What is the preferred technique for cricothyroidotomy?

Answer 25

Bougie-assisted open surgical technique.

Question 26

How is the incision made in cricothyroidotomy?

Answer 26

Vertical skin incision, horizontal membrane incision.

Question 27

What confirms correct tube placement in cricothyroidotomy?

Answer 27

Bilateral chest rise, breath sounds, capnography.

Question 28

What are complications of cricothyroidotomy?

Answer 28

Bleeding, misplacement, subcutaneous emphysema, infection.

Question 29

What is the maximum time cricothyroidotomy is recommended for?

Answer 29

Ideally less than 72 hours before formal tracheostomy.

Question 30

What ventilation method may follow cricothyroidotomy?

Answer 30

Bag-valve mask ventilation or mechanical ventilation.

Question 31

What is the danger of high PEEP in chest trauma?

Answer 31

May worsen tension pneumothorax or reduce venous return.

Question 32

What is a tension pneumothorax?

Answer 32

Air trapped in pleural space under pressure, impairing ventilation and circulation.

Question 33

What are signs of tension pneumothorax?

Answer 33

Hypotension, distended neck veins, absent breath sounds.

Question 34

What should you monitor continuously in ventilated patients?

Answer 34

Respiratory rate, oxygen saturation, ETCO2.

Question 35

What oxygen saturation is targeted in trauma ventilation?

Answer 35

≥ 94%.

Question 36

Why is early cricothyroidotomy preferred in facial trauma?

Answer 36

Facial injuries may obstruct other airway methods.

Question 37

What is the purpose of preoxygenation before cricothyroidotomy?

Answer 37

To increase oxygen reserves during the procedure.

Question 38

Why is auscultation important post-ventilation or tube placement?

Answer 38

To confirm bilateral air entry and detect complications.

Question 39

What is a common cause of failed ventilation in the field?

Answer 39

Dislodged airway or pneumothorax.

Question 40

How often should chest drains be checked in tactical care?

Answer 40

Continuously for function and complications.

Question 41

What is the danger of occluding a chest wound without a vent?

Answer 41

Can convert to a tension pneumothorax.

Question 42

What is a 'surgical airway'?

Answer 42

An invasive airway such as a cricothyroidotomy.

Question 43

What is an alternative to surgical cricothyroidotomy in trained hands?

Answer 43

Needle cricothyroidotomy (temporary).

Question 44

Why is bougie important in cricothyroidotomy?

Answer 44

Guides correct tube placement into the trachea.