Airway management: early tracheostomy dislodgement: 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 management: early tracheostomy dislodgement

Sample item

A patient with a 3-day-old tracheostomy is decannulated accidentally and becomes hypoxic. What is the safest approach?

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

The answer and the reasoning

A. Give oxygen to the face and stoma and secure the airway by oral intubation, avoiding blind reinsertion

In the first week the tract has not matured, so blind reinsertion can create a false passage into the pre-tracheal tissues and cause fatal hypoxia and emphysema. The recommended approach is to call for help, oxygenate through the mouth and stoma, and intubate orally from above. Reinsertion under direct vision or bronchoscopic guidance may be attempted by experienced staff.

Option by option

  • A. Give oxygen to the face and stoma and secure the airway by oral intubation, avoiding blind reinsertion (correct)

    Correct. Oral intubation and oxygenation avoid creating a false passage.

  • B. Wait for the patient to recover

    Waiting leaves a hypoxic patient untreated.

  • C. Insert a nasopharyngeal airway into the stoma

    A nasopharyngeal airway in the stoma does not secure the airway.

  • D. Blindly reinsert the tracheostomy tube repeatedly

    Repeated blind reinsertion risks false passage and death.

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.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is A, Give oxygen to the face and stoma and secure the airway by oral intubation, avoiding blind reinsertion. In the first week the tract has not matured, so blind reinsertion can create a false passage into the pre-tracheal tissues and cause fatal hypoxia and emphysema.

Why is "Wait for the patient to recover" not the answer?

Waiting leaves a hypoxic patient untreated.

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

A nasopharyngeal airway in the stoma does not secure the airway.

Why is "Blindly reinsert the tracheostomy tube repeatedly" not the answer?

Repeated blind reinsertion risks false passage and death.

What concept does this question test?

It tests Airway management: early tracheostomy dislodgement in Anaesthesia. The recommended approach is to call for help, oxygenate through the mouth and stoma, and intubate orally from above. Reinsertion under direct vision or bronchoscopic guidance may be attempted by experienced staff.

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 management: early tracheostomy dislodgement?

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.