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Chapter 54. Airway Management of the Pregnant Trauma Victim

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Which of the following anesthetic induction agents has been shown in clinical trials to be safe for a pregnant patient?

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A. etomidate

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B. propofol

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C. thiopental

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D. ketamine

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E. none of the above

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(E) No high-quality evidence confirms that any of these medications are absolutely safe during pregnancy though all are used routinely.

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During a rapid sequence induction for an emergency cesarean section, you are neither able to intubate nor oxygenate the patient. Which of the following is NOT an appropriate course of action?

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A. repeat laryngoscopy and intubation

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B. ventilation using Combitube™

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C. immediate preparations for cricothyrotomy

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D. ventilation using an LMA

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E. relaxing cricoid pressure to determine if BMV can be improved

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(A) In a “can’ intubate, can’t oxygenate” situation, all of the options are acceptable except to repeat a “failed” technique.

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Which of the following is NOT an indication to deliver the fetus in a trauma victim who is 37 weeks pregnant?

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A. to aid in the resuscitation of the mother, the fetus must be delivered in an expeditious fashion

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B. maternal cardiac arrest

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C. hemodynamically stable mother and the fetus is showing signs of terminal fetal distress with severe fetal bradycardia

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D. the mother is hemodynamically unstable secondary to hemorrhage and placental abruption

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E. maternal respiratory arrest

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(E) In a respiratory arrest, the most important management is to restore ventilation and oxygenation immediately.

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