Airway Management, Ventilation, and Oxygenation
Core concepts
Candidates must be able to classify airways as patent, partially obstructed, or obstructed, and choose basic (positioning, suction, OPA/NPA, BVM) versus advanced (supraglottic airway, endotracheal intubation, surgical airway) interventions. Know the indications, contraindications, and sizing rules for each adjunct. Ventilation concepts include tidal volume, rate, minute ventilation, compliance, and the difference between oxygenation (SpO2, FiO2, PaO2) and ventilation (PaCO2, EtCO2). Understand oxygen delivery devices and their approximate FiO2 ranges, pulse oximetry limitations, capnography waveform interpretation, and the recognition of inadequate ventilation by clinical signs rather than numbers alone.
Traps in questions
Watch for questions that conflate oxygenation with ventilation: a normal SpO2 does not exclude hypercapnia. Be alert to device selection where the patient's respiratory drive matters (hypoxic drive in chronic CO2 retention), to contraindications for NPA (basal skull fracture signs) and OPA (intact gag reflex), and to pediatric sizing by age/weight rather than adult rules. Gastric insufflation during BVM is a common distractor; the correct answer usually emphasizes adequate mask seal and just enough volume to see chest rise.
Rule of thumb
If the patient is unresponsive with no gag reflex and no spontaneous breathing, the priority sequence is: open airway, suction if needed, insert OPA, ventilate with BVM and 100% oxygen, then consider advanced airway. Confirm every advanced airway with waveform capnography plus clinical assessment; never rely on auscultation alone.