Airway management: cannot intubate cannot oxygenate: 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: cannot intubate cannot oxygenate

Sample item

After failed intubation and failed supraglottic airway, a patient remains hypoxic with no oxygenation by face mask. What is the next step?

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

The answer and the reasoning

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

In a cannot intubate cannot oxygenate situation, the Difficult Airway Society pathway calls for immediate scalpel-bougie-tube cricothyroidotomy. Delay leads to hypoxic brain injury within minutes.

Option by option

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

    Correct. Front-of-neck access is the rescue.

  • B. Repeat the same laryngoscopy

    Repeated attempts waste time during hypoxia.

  • C. Give a larger dose of suxamethonium

    More suxamethonium will not help oxygenation and adds risk.

  • D. Wait for spontaneous breathing

    Waiting will not restore oxygenation after paralysis.

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, Emergency front-of-neck access (cricothyroidotomy). In a cannot intubate cannot oxygenate situation, the Difficult Airway Society pathway calls for immediate scalpel-bougie-tube cricothyroidotomy.

Why is "Repeat the same laryngoscopy" not the answer?

Repeated attempts waste time during hypoxia.

Why is "Give a larger dose of suxamethonium" not the answer?

More suxamethonium will not help oxygenation and adds risk.

Why is "Wait for spontaneous breathing" not the answer?

Waiting will not restore oxygenation after paralysis.

What concept does this question test?

It tests Airway management: cannot intubate cannot oxygenate in Anaesthesia. Delay leads to hypoxic brain injury within minutes.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: cannot intubate cannot oxygenate?

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.