6 - ENT - Upper airway - Obstruction - Emergency airway management

Question 1

when would cricothyroidectomy be done

Answer 1

• obstruction is at or above level of larynx, so endotracheal intubation not possible
• severe maxillofacial trauma

Question 2

3 dif methods for cricothyroidectomy

Answer 2

needle
cricoidotomy kit
surgical

Question 3

describe needle method of cricothyroidectomy

Answer 3

large bore canula into cricothyroid membrane at 45 degrees (sup)
give oxygen through cannula

Question 4

describe surgical method of cricothyroidectomy

Answer 4

usually only >12y

incision in cricothyroid membrane, parting of tissue, insertion of short ET tube

Question 5

Complications of cricothyroidectomy

Answer 5

laryngeal/tracheal trauma
recurrent laryngeal nerve damage
haemorrhage
oesphageal perforation

Question 6

Indications for a tracheotomy - 6

Answer 6

• bypass UAO
• prevent UAO due to swelling after H+N surgery
• prevent aspiration in neuro condition
• allow respiration following laryngectomy
• protect lungs from UA bleeding
• in long term mechanical ventilation

Question 7

Trachy - role of cuff + fenestration

Answer 7

cuff - allows seal for ventilation, prevents aspiration from above level of cuff
fenestration - allows air to pass through on expiration into larynx for speech

Question 8

Trachy - role of speaking valve + reservoir

Answer 8

speaking valve - allows air to enter during inspiration + closes on inspiration
reservoir- allows cuff pressure to be checked

Question 9

early complications of Trachy

Answer 9

blockage
displacement
surgical emphysma
pneumothorax
infection
dysphagia

Question 10

late complications of Trachy

Answer 10

tracheal erosion or stenosis
tracheo oesophageal fistula
persistent tracheocutaneous fistula
tracheitis