Certified Registered Nurse Anesthetist (CRNA) Practice Exam

Can tracheal intubation fully prevent aspiration?

1. Yes, it completely prevents aspiration

2. No, micro aspiration can still occur

3. Only in patients with strong gag reflexes

4. Only during emergency procedures

The correct answer is: No, micro aspiration can still occur

Tracheal intubation is a procedure used to secure the airway and facilitate ventilation. While it significantly reduces the risk of aspiration by creating a barrier between the trachea and the oral cavity, it does not completely prevent aspiration. This is because micro-aspiration can still occur, particularly if there are factors such as anatomical variations or dysfunction of the upper airway protective reflexes. Micro-aspiration refers to small amounts of fluid or secretions entering the trachea and lungs, which can happen despite the presence of an endotracheal tube. In situations where there is increased intra-abdominal pressure, such as during positive pressure ventilation, or in certain patient populations with impaired swallowing or protective airway reflexes, the risk for aspiration may still exist, leading to potential pulmonary complications. Understanding that tracheal intubation greatly decreases the likelihood of significant aspiration episodes but does not entirely eliminate the risk is essential for managing patients’ airways effectively.