Name two common intraoperative airway emergencies and one initial management step for each.

• A. Laryngospasm — apply jaw thrust, CPAP, deepen anesthesia; Bronchospasm — administer bronchodilators, ensure adequate anesthesia and ventilation
• B. Laryngospasm — lower oxygen; Bronchospasm — withhold ventilation
• C. Laryngospasm — administer epinephrine; Bronchospasm — perform CPR
• D. Laryngospasm — remove airway devices; Bronchospasm — stop ventilation entirely

Answer: (A)

The situation tests recognizing two common intraoperative airway emergencies and starting the right first steps to restore airway patency and ventilation.

Laryngospasm happens when the vocal cords forcibly constrict, blocking the airway. The immediate approach is to open and splint the airway: use a jaw thrust to relieve obstruction, apply positive pressure ventilation with CPAP to keep the airway open, and deepen anesthesia to suppress the reflex that caused the spasm. These actions address both the mechanical blockage and the reflex-driven tightening, helping to restore airflow quickly.

Bronchospasm is a constriction of the small airways, making ventilation difficult and causing wheeze and rising airway pressures. The best first step is to administer a bronchodilator to relax the smooth muscle of the bronchi, while ensuring adequate oxygenation and ventilation—often by continuing or increasing anesthesia depth with volatile agents and delivering 100% oxygen as needed. This tackles the underlying bronchial constriction and supports effective ventilation.

The other options don’t fit the typical immediate needs: lowering oxygen or withholding ventilation would worsen gas exchange; giving epinephrine or performing CPR is reserved for other emergencies or situations (like anaphylaxis or cardiac arrest) rather than the common initial steps for these airway issues; removing airway devices or stopping ventilation entirely would not promptly address the problem.