Chapter 16. What Is Unique About Airway Management in the Pre-Hospital Setting?
Rapid sequence intubation by non-physician pre-hospital care providers
A. is regulated by federal statute
B. is safe in adults but not children
C. is well established for paramedics
D. is supported by the available evidence for critical care pre-hospital providers
E. will replace EGDs in the foreseeable future
(D) All the other statements are incorrect except that rapid sequence intubation by nonphysician pre-hospital care providers is supported by the available evidence for critical care pre-hospital providers.
All of the following statements about “non-paralytic RSI” are correct EXCEPT
A. some jurisdictions permit paramedics to employ this technique
B. it has been proven to be safer than “paralytic RSI”
C. it employs an induction agent at full dose but no neuromuscular blocking agent
D. it provides an inferior view of the glottis
E. it is felt to be more humane than intubating patients awake
(B) All of the statements about “non-paralytic RSI” are correct EXCEPT that “non-paralytic RSI” has not been proven to be safer than “paralytic RSI.”
All of the following statements regarding qualitative, colorimetric end-tidal carbon dioxide determination in EMS are correct EXCEPT
A. continuous monitoring is indicated to identify inadvertent extubation during transport
B. these devices enable one to adhere to the standard of care for confirmation of endotracheal intubation
C. these devices are almost totally unreliable in patients having suffered a cardiac arrest
D. they are more effective than esophageal detector devices in confirming endotracheal placement
E. they are neither better nor worse than capnograpy in confirming correct endotracheal tube placement
(C) While the colorimetric end-tidal carbon dioxide determination is effective to confirm tracheal intubation, it is less accurate in identifying correct placement of the ETT in patients with circulatory arrest, with reported false negative rates as high as 30% to 35%.