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Dr. Pilbeam asks you to assess a patient for an adequate leak prior to extubation. The patient is on CPAP of 5 cmH2O; therefore, you place the patient back on VC-CMV with a set VT of 600 mL. Based on the cuff-leak test in the “AARC Guidelines for Removal of the Endotracheal Tube”, what is the minimum leak volume that would be considered acceptable? (you must show your work on provided paper).

Identify the best cause of the following capnogram: reduced perfusion cap.png 

Soon after endotracheal tube extubation, an adult patient exhibits a high-pitched inspiratory noise, heard without a stethoscope and vital signs are stable. What actions would you recommend?

Which medication is supplied for use with this device? You may provide the brand or generic name. pulmicort.png 

Which of the following is most likely to occur due to too far advancement of the tube exchanger? 

Mr. Cass is a 5’11 male requiring endotracheal intubation. According to Egan’s rule of thumb, the most appropriate ETT size to select for Mr. Cass is:

An attempt at intubating should not exceed:

Identify the cause of this capnograph: bronchoconstriction cap.png 

Mrs. Miller is orotracheally intubated with a size 7.5 mm ETT. It has been determined that Mrs. Miller’s ETT needs to be replaced. The physician has instructed you to change the tube with a tube exchanger. According to the CXR, Mrs. Miller’s ETT is 3 cm above the carina. Refer to the image below to answer the following question. Using the ETT placement at the corner of the mouth as your landmark, the safest minimal to maximal depths to insert and maintain the tube exchanger during the exchange is: ET tube position.png 

While monitoring capnography during mechanical ventilation, you note the PetCO2 has increased from 20 mmHg to 40 mmHg. All the following are potential causes except: