ANSWERS

CHAPTER 1

• 1.1. (D) While others may play a significant role, the most common factor leading to a failed airway is failure to predict a difficult airway.

• 1.2. (E) The standard of care is the conduct and skill of an average and prudent practitioner that can be expected by the practitioner’s peers and a “reasonable patient,” and not the opinions offered by experts.

• 1.3. (B) The standard of care does not expect the average, reasonable airway practitioner to be an expert and have the expertise in using highly technical airway techniques.

CHAPTER 2

• 2.1. (A) With the exception of reputable organizations, all are important features of well-designed, clinically useful algorithms.

• 2.2. (C) The ASA Practice guidelines are not intended as standards or absolute requirements as the use of practice guidelines cannot guarantee any specific outcome.

• 2.3. (B) National airway guidelines are published as recommendations to the practitioner. Most include the advice to avoid multiple attempts at any one technique or device, and to advance step-wise from one technique or device to another to maintain patient oxygenation.

CHAPTER 3

• 3.1. (D) The internal branch of the superior laryngeal nerve contributes sensory fibers to the posterior surface of the epiglottis, the laryngopharynx, laryngeal mucosa of the true vocal cords, as well as the base of tongue.

• 3.2. (C) The maximum effective concentration of topical lidocaine applied to the oropharynx is 4%.

• 3.3. (B) During translaryngeal anesthesia, correct needle placement is confirmed by aspiration of air through the syringe.

CHAPTER 4

• 4.1. (C) The ester linkage of remifentanil renders it susceptible to cleavage by nonspecific plasma and tissue esterases.

• 4.2. (B) The suggested dose for the reversal of rocuronium induced deep neuromuscular block is 4 mg·kg⁻¹.

• 4.3. (A) In the event of a “can’t intubate, can’t oxygenate” situation the rescue reversal of rocuronium at an RSI dose of 1.2 mg·kg⁻¹ may not result in the return of spontaneous ventilation prior to significant oxygen desaturation.

• 4.4. (B) Dexmedetomidine is shorter acting than clonidine and is more selective for alpha 2 adrenoreceptor versus alpha 1 adrenoreceptors

CHAPTER 5

• 5.1. (C) 30 N is more than enough to prevent regurgitation into the pharynx in most patients. Pressures of greater than 30 N (approximately 3 kg, or 7 lb) are unlikely to be necessary. The originally described forces (40 N) would rarely be necessary to prevent gastric regurgitation.

• 5.2. (D) All of the statements about cricoid pressure and airway techniques are true, including that cricoid pressure can also affect ventilation via a face mask.

• 5.3. (E) All except young children are known factors that increase the risk of aspiration.

CHAPTER 6

• 6.1. (E) According to the Coroner’s Inquest on the death of Elaine Bromiley, the team ...