Airway: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Airway

Sample item

After induction and neuromuscular blockade, repeated intubation attempts fail. Face-mask ventilation and a supraglottic airway also fail, and oxygen saturation is falling rapidly. What is the most appropriate next step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Emergency front-of-neck access (cricothyroidotomy)

Failure of intubation, face-mask ventilation and supraglottic airway with falling saturation is a cannot intubate, cannot oxygenate situation. The final rescue step in difficult airway algorithms is immediate front-of-neck access through the cricothyroid membrane. Delay leads to hypoxic brain injury.

Option by option

  • A. Wait for spontaneous recovery from the relaxant

    Waiting for recovery is unsafe because hypoxia progresses far faster than the drug wears off.

  • B. Emergency front-of-neck access (cricothyroidotomy) (correct)

    Correct. A surgical or cannula airway through the cricothyroid membrane bypasses the failed upper airway.

  • C. More laryngoscopy attempts by the same operator

    Repeated attempts cause trauma and oedema and lose critical time.

  • D. Insert a nasopharyngeal airway

    A nasopharyngeal airway cannot overcome complete failure of ventilation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Anaesthesia questions

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Emergency front-of-neck access (cricothyroidotomy). Failure of intubation, face-mask ventilation and supraglottic airway with falling saturation is a cannot intubate, cannot oxygenate situation.

Why is "Wait for spontaneous recovery from the relaxant" not the answer?

Waiting for recovery is unsafe because hypoxia progresses far faster than the drug wears off.

Why is "More laryngoscopy attempts by the same operator" not the answer?

Repeated attempts cause trauma and oedema and lose critical time.

Why is "Insert a nasopharyngeal airway" not the answer?

A nasopharyngeal airway cannot overcome complete failure of ventilation.

What concept does this question test?

It tests Airway in Anaesthesia. The final rescue step in difficult airway algorithms is immediate front-of-neck access through the cricothyroid membrane. Delay leads to hypoxic brain injury.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Airway?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.