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Residency ED Rotation: Orotracheal Intubation
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1. Orotracheal intubation is indicated for all of the following patients except:
patient admitted for chest pain goes into cardiac arrest
patient in anaphylactic shock, with upper airway occluded by swelling
patient being admitted for laparoscopic cholecystectomy
patient with pneumothorax in respiratory distress
2. Which of the following is true about preparation for orotracheal
intubation?
Extension of the patient’s neck improves oropharynx and larynx alignment
Firm pressure on the cricoid cartilage helps maintain tracheal patency
Preoxygenation of the patient reduces the need for positive-pressure
ventilation during intubation
Sedative administration increases the risk of aspiration of gastric contents
3.Correct orotracheal intubation procedure involves:
insertion of the endotracheal tube into the right side of the patient’s mouth
placement of a curved laryngoscope blade posterior to the epiglottis
placement of a straight laryngoscope blade into the vallecula of the epiglottis
inflation of the endotracheal balloon when it reaches the vocal cords
4. If you cannot visualize the vocal cords after placing the laryngoscope
blade, you should:
withdraw laryngoscope blade completely, reposition and insert blade again
gradually advance laryngoscope blade while manipulating the larynx
ask an assistant to apply firm upward pressure to the larynx
all of the above
5. Proper endotracheal tube placement may be confirmed by:
auscultation of gurgling sounds over the epigastrium during positive-
pressure ventilation
carbon dioxide detection and auscultation of equal, bilateral breath sounds
observation of patient’s chest rising and falling and inability to speak
chest radiograph showing radio-opaque tube line in the right main bronchus
6. The most serious complication of orotracheal intubation is:
aspiration of gastric contents
bradycardia
exacerbation of cervical spine trauma
unrecognized esophageal intubation