Certified Registered Nurse Anesthetist (CRNA) Practice Exam

What should be done immediately after a failed intubation and inadequate two-handed mask ventilation?

1. Call for help

2. Insert an LMA

3. Attempt intubation again

4. Begin bag-mask ventilation

The correct answer is: Insert an LMA

In the context of airway management during anesthesia, following a failed intubation and inadequate two-handed mask ventilation, the appropriate immediate action is to insert a laryngeal mask airway (LMA). The LMA serves as a practical alternative airway management tool when conventional intubation methods fail and bag-mask ventilation is ineffective. The LMA allows for passive ventilation and provides a clear route for secure airway management without the need for a direct endotracheal tube position. This is vital in preventing hypoxia and maintaining patient safety while preparing for further airway management strategies. LMA insertion can facilitate oxygenation and ventilation until a more definitive airway solution can be identified or employed, such as reattempting intubation, which requires a stable and adequately ventilated patient. Thus, the LMA is an effective and immediate step in managing a critical situation where traditional ventilation methods have not succeeded, helping to ensure the patient's airway is managed appropriately.