RT-05 · Initiation & Modification

Airway Management: Intubation, Tracheostomy & Suctioning

Tube selection, placement confirmation, cuff management, suctioning technique, and the emergency airway decisions the exam asks about most.

~26 min read3 concept sections·4 questions with rationale

What you'll be able to do

  • Select tube size, blade, and adjuncts for an intubation
  • Confirm placement with the correct hierarchy of evidence
  • Manage cuff pressure and prevent tracheal injury
  • Suction safely and recognize suction-related complications
Concept breakdown
01

Setup and tube selection

Every intubation question starts with equipment. If the setup is wrong, no later answer choice saves the patient.

  • Adult ETT: 7.0–8.0 mm for women, 8.0–9.0 mm for men. Larger tubes lower resistance and allow bronchoscopy.
  • Pediatric uncuffed tube size = (age/4) + 4; cuffed = (age/4) + 3.5. Depth ≈ tube size × 3.
  • Adult ETT depth at the teeth: 21 cm for women, 23 cm for men — then confirm, never assume.
  • Preoxygenate with 100% for 3–5 minutes, and have suction, a bag-mask, a stylet, and a backup smaller tube in reach before the blade touches the mouth.
At the bedside

MOANS and LEMON exist because the failed airway is predicted before it happens. Assess the airway before sedating.

Practice quiz

Check yourself before you read the rationale.

Question 1 of 1

Immediately after intubation of a patient in cardiac arrest, the colorimetric CO2 detector fails to change color. The most appropriate action is:

Practice questions

Answer first, then read why the distractors fail.

Question 1

Immediately after intubation of a patient in cardiac arrest, the colorimetric CO2 detector fails to change color. The most appropriate action is:

Members only

2 more concept sections, 3 more questions, and the exam-day playbook for this module.

The free preview above gives you the opening concept, sample quiz, and practice questions. Unlock the full module for every breakdown, bedside note, rationale-driven question, and the test-day playbook.

Checking your access…

Keep going

Other RRT guides in the library

RT-01

Arterial Blood Gas Interpretation

A repeatable four-step read of any ABG — acid-base status, compensation, oxygenation, and the clinical story that produced it.

→
RT-02

Mechanical Ventilation Fundamentals

Modes, initial settings, and the pressure readings that tell you whether the problem is the circuit, the airway, or the lung.

→
RT-03

Oxygen Delivery Devices

Low-flow versus high-flow logic, deliverable FiO2 ranges, and how to choose the device that matches the patient's inspiratory demand.

→
RT-04

Pulmonary Function Test Interpretation

How to sort obstructive from restrictive patterns, grade severity, and read the bronchodilator and diffusion results that follow.

→
RT-06

Mechanical Ventilation: Monitoring, Graphics & Waveforms

Reading scalars and loops to localize a problem — resistance versus compliance, auto-PEEP, asynchrony, and leaks — before touching a setting.

→
RT-07

Ventilator Weaning, Liberation & Extubation

Readiness criteria, the spontaneous breathing trial, the numbers that predict success, and how to recognize post-extubation failure early.

→
RT-08

Noninvasive Ventilation, CPAP & BiPAP

Who benefits, who must be intubated instead, how to set IPAP and EPAP, and how to tell in two hours whether NIV is working.

→
RT-09

Patient History, Chart Review & Physical Assessment

Building the clinical picture before you touch a device — history, vitals, inspection, auscultation, and the lab values that change respiratory decisions.

→
RT-10

Pharmacology: Bronchodilators, Steroids & Adjunct Agents

Drug classes by mechanism, dosing, side effects, and the exam's favorite question: which agent for this patient, right now.

→
RT-11

Chest Radiograph & Imaging Interpretation

A systematic read of the portable film — line and tube position, the classic pathology patterns, and what imaging can and cannot answer.

→
RT-12

Humidity, Aerosol Therapy & Bland Aerosol

Choosing humidifiers and nebulizers, particle size and deposition, delivery technique, and the troubleshooting the exam expects.

→
RT-13

Bronchial Hygiene, Lung Expansion & Hyperinflation Therapy

Secretion clearance and lung expansion therapies — who needs which, how to judge effectiveness, and when to stop.

→
RT-14

Emergency Care, ACLS, Resuscitation & Transport

The therapist's role in codes: high-quality CPR metrics, airway and ventilation during arrest, capnography feedback, and safe transport.

→
RT-15

Neonatal & Pediatric Respiratory Care

Delivery room resuscitation, surfactant, neonatal ventilation targets, and the pediatric airway differences that change every decision.

→
RT-16

Hemodynamic Monitoring & Cardiac Assessment / ECG

Reading pressures and rhythms the way a therapist must: what the number means, what it changes, and which rhythm needs action now.

→
RT-17

Infection Control, Sterilization & Equipment Quality Control

Isolation precautions, disinfection levels, equipment processing, and the quality control checks the exam expects you to perform and interpret.

→
RT-18

Chronic Disease Management, Home Care & Pulmonary Rehab

Long-term oxygen criteria, home equipment selection, sleep-disordered breathing, patient education, and rehabilitation outcomes.

→
RT-19

Equipment Assembly & Troubleshooting

The NBRC tests equipment failure constantly: what breaks, what the patient looks like when it breaks, and the fix you perform before you call anyone.

→
RT-20

Medical Gas Supply & Cylinder Systems

Cylinder duration math, safety index systems, regulators, and bulk supply — the calculation questions you can guarantee will appear.

→
RT-21

Sleep-Disordered Breathing & Titration

Obstructive versus central events, AHI severity, and how a CPAP or bilevel titration is actually driven overnight.

→
RT-22

Bronchoscopy & Special Procedures

Assisting with bronchoscopy, thoracentesis, chest tubes, and arterial lines — the setup, the monitoring, and the complication you must catch.

→
RT-23

Protocols, Documentation & Professional Ethics

Therapist-driven protocols, charting that holds up, scope of practice, and the ethics questions the NBRC scores as clinical judgment.

→
RT-24

Capnography & Bedside Monitoring

Waveform capnography, the PaCO2–EtCO2 gradient, pulse oximetry limits, and the monitors that tell you the truth before the gas does.

→
RT-25

Specialty Gas Therapy: Heliox, Nitric Oxide & Hyperbarics

When density, selective vasodilation, or dissolved oxygen is the therapy — indications, delivery, monitoring, and the toxic endpoints.

→
RT-26

Tracheostomy & Long-Term Airway Care

Tube anatomy, cuff management, speaking valves, decannulation, and the emergency that kills — a dislodged fresh trach.

→
RT-27

Laboratory Data & Microbiology Interpretation

Electrolytes, CBC, coagulation, cardiac and sputum data read the way a respiratory therapist has to read them.

→
RT-28

Patient Transport & Disaster Response

Intrahospital and flight transport planning, gas supply math under pressure, and triage when resources run out.

→
RT-29

Pulmonary Rehabilitation, Education & Smoking Cessation

Exercise prescription, breathing retraining, adherence teaching, and the cessation counseling the exam expects you to deliver.

→