09-08-2010, 02:10 PM
You are present during the intubation of an 87-year-old man who was found unconscious by his nurse.
The patient was admitted to the hospital that morning after a syncopal episode. He has a past medical
history of coronary artery disease and is status-post a Q-wave myocardial infarction and a 3-vessel
bypass procedure 7 months ago. This morning, he had a syncopal episode that was preceded by
palpitations and chest pressure. About 10 minutes ago, his nurse heard a fall and came to the room to
find the patient on the floor, pulseless and apneic. A senior medicine attending places the
endotracheal tube via direct laryngoscopy. The most sensitive method for the detection of an
appropriately placed tube is
A. absence of air heard in the stomach
B. bilateral breath sounds
C. detection of end-tidal carbon dioxide
D. restoration of 100% saturation by pulse oximetry
E. rise and fall of the chest with positive pressure respirations
The patient was admitted to the hospital that morning after a syncopal episode. He has a past medical
history of coronary artery disease and is status-post a Q-wave myocardial infarction and a 3-vessel
bypass procedure 7 months ago. This morning, he had a syncopal episode that was preceded by
palpitations and chest pressure. About 10 minutes ago, his nurse heard a fall and came to the room to
find the patient on the floor, pulseless and apneic. A senior medicine attending places the
endotracheal tube via direct laryngoscopy. The most sensitive method for the detection of an
appropriately placed tube is
A. absence of air heard in the stomach
B. bilateral breath sounds
C. detection of end-tidal carbon dioxide
D. restoration of 100% saturation by pulse oximetry
E. rise and fall of the chest with positive pressure respirations