airway management is the process of maintaining ventilation in a patient by using an artificial
airway this ensures that gas exchange can occur by establishing a link between the patient
and the ventilator which is important because we need to make sure that the patient's upper airway
is free and clear of foreign substances so that air can flow into and out of the lungs it goes
without saying that this is a very important topic in the field of respiratory care as a student
you must develop an understanding of the basic concepts to use throughout your career
as a respiratory therapist but even before that you must know and understand airway management
in order to pass the board exams as well so to help in this video we're going to break down
a few sample tmc practice questions on this very topic so if you're ready let's get into it
a 61 year old female patient was just intubated and is now receiving ventilatory support
via an oral endotracheal tube you recommended a chest radiograph in order to confirm proper
placement of the tube where should the tip of the tube be positioned
a not more than two centimeters above the carina b at the same level as the carina
c level with the fifth cervical vertebrae or d between the second and fourth thoracic vertebrae
do you know the answer let's break it down first and foremost you absolutely must know the proper
position of an endotracheal tube for the tmc exam because you will see questions about it just know
that there are a few ways to confirm proper placement that you should be familiar with when
looking at a chest x-ray a properly positioned et tube should appear about 1.5 inches above the
carina which to be more specific is about four to six centimeters this means that the tip of
the tube will sit between the second and fourth thoracic vertebrae on the x-ray another quick
and general reference to look at is this the tube should be inserted about 21 to 24 centimeters at
the patient's lip which you can verify by looking at the markings on the tube so by looking at the
answer choices we can quickly see that only one option shows that the tube is in the correct place
which means that the correct answer has to be d between the second and fourth thoracic vertebrae
before we move along to the next question i just wanted to let you know about our tmc test
bank it's our massive bank of premium practice questions that many students have been using
to prepare for and pass the tmc exam going through practice questions is by far one of
the most effective preparation strategies and that is exactly why so many of our recent students have
been successful our practice questions cover every topic that you're required to know for the exam
including the topics that unfortunately many students forget to study if you're interested
we're actually running a temporary promotion that you can take advantage of just pause this video
and check it out i'll drop a link right below this video down in the description 63 year old
female patient is orally intubated with a size 7 endotracheal tube and is receiving ventilatory
support while attempting to suction the patient with a size 12 catheter you note that it cannot
pass beyond the tip of the tube which of the following is the most likely cause of this problem
a there is a kink in the tube b the tube is in the right main stone bronchus c
the suction catheter is too short or a d the suction catheter size is too large do you know
the correct answer well let's break it down after reading the question and answer choices first we
must determine if the right size suction catheter is being used a quick and simple way to do so
is to double the et tube size and then make it the next size down for example the question tells
us that the patient has a size 7 endotracheal tube so now we can double that number to get 14.
then we need to take the next smallest catheter size which would be a size 12.
this confirms that a size 12 catheter is the appropriate size for a size 7 endotracheal tube
so now looking back at the answer choices this means that we can roll out c and d automatically
in general whenever you are unable to pass a suction catheter down the et tube it usually
indicates that there is some type of obstruction and the most common types include mucus plugs
kinking or when the patient is biting the tube even if the tube is in the right mainstream
bronchus you should still be able to pass the suction catheter beyond the tip of the tube
so by reading the question carefully and using our knowledge of endotracheal tubes and suction
catheters we could determine that the correct answer has to be a there is a kink in the tube
if you're enjoying this video so far do me a huge favor and hit the like button
it really helps support the channel and i really do appreciate it more than you know
also if you haven't done so already be sure to subscribe for more videos like this
but we're not done yet let's break down another practice question
what purpose does the pilot balloon of an endotracheal or tracheostomy tube
serve during intubation and airway management a to minimize mucosal trauma during insertion
b to protect the airway against aspiration c to monitor cuff integrity and pressure
or d to help with proper tube positioning do you know the answer well let's break it down
the cuff of an endotracheal and tracheostomy tube is designed to help seal the airway for protection
and facilitate positive pressure ventilation however hanging from the cuff is what's known as a
pilot balloon which is used to monitor the cuff's integrity and pressure once the tube is in place
it has a valve in which a syringe is attached for the inflation and deflation of the cuff this can
be done simply by pumping air into the cuff for inflation or removing air to deflate the cuff
you should know that in general the pilot balloon is not meant to help with tube positioning
preventing aspiration or minimizing trauma so by using what we know about pilot balloons as well
as the process of elimination we could determine that the correct answer has to be c to monitor
cuff integrity and pressure real quick guys do me a huge favor and hit the like button it really
helps support the channel and i greatly greatly appreciate it and while you're down there go ahead
and click the subscribe button as well because we have a ton of other videos on our channel that i
think you will enjoy well what'd you think about these practice questions was it helpful breaking
them down in a simplified way i hope so and as i always say definitely try to go through as many
of these as possible when preparing for the tmc exam even if you don't use our practice questions
this is still a strategy that i recommend for all students however if you do want to get
access to all of our premium practice questions definitely consider checking out our tmc test bank
you can still take advantage of the temporary promotion that's going on by using the link below
also if you want to get these practice questions and explanations sent straight to your inbox on
a daily basis you can consider signing up for our practice questions pro membership
which costs less than one of those fancy cups of coffee that all the kids are drinking these days
it's never been easier all you have to do is sign up and we'll send the practice questions to your
email address each and every day small tidbits of knowledge over time can add up to huge results
i'll drop a link to that as well right below this video down in the description thank you
so much for watching all the way to the end have a blessed day and as always breathe easy my friend
you