Which airway management device cannot be used if performing IPPV?

• A. Endotracheal tube
• B. Laryngeal mask airway
• C. Supraglottic device
• D. Tracheostomy tube

Answer: (C)

Intermittent positive pressure ventilation needs a secure airway that seals inside the trachea and protects against aspiration. A supraglottic device sits above the glottis and does not provide a reliable below-glottic seal or robust airway protection under positive pressure. Because of that, it isn’t suitable for IPPV. In contrast, an endotracheal tube or a tracheostomy tube provides a cuffed, intratracheal airway that can safely deliver controlled ventilation. The laryngeal mask airway is a specific supraglottic option that can be used for ventilation in some settings, but the general supraglottic approach does not meet the requirements for reliable IPPV, which is why it’s the best answer.