Advanced Cardiovascular Life Support (ACLS) Practice Exam

In which situation is immediate advanced airway placement recommended?

1. In cases of asystole

2. For patients with extreme agitation

3. When a patient's respiratory effort is inadequate despite ventilation

4. If the patient is unconscious but breathing normally

The correct answer is: When a patient's respiratory effort is inadequate despite ventilation

Immediate advanced airway placement is recommended when a patient's respiratory effort is inadequate despite ventilation because this indicates that standard ventilation methods are not sufficient to maintain adequate oxygenation and ventilation. In such scenarios, the risks of hypoxia and hypercapnia increase, which can lead to further complications. Advanced airway management, such as endotracheal intubation or supraglottic airway placement, can secure the airway and ensure that oxygen can be delivered effectively, thus addressing the immediate life-threatening situation. In the case of asystole, while it is a critical condition requiring urgent intervention, airway management is not prioritized over other life-saving measures, such as high-quality CPR and administering epinephrine. For patients with extreme agitation, while advanced airway management might be considered if their airway is at risk, the primary approach should focus on sedation and assessing the cause of the agitation before escalating to advanced airway techniques. If a patient is unconscious but breathing normally, airway placement may not be immediately necessary. The priority would be to monitor the patient's airway and ensure it remains patent, as normal breathing indicates sufficient respiratory function at that moment.