- ADVANCED AIRWAY Mx (CLINICAL) -

Question 1

Demonstrate the jaw thrust /

chin lift technique

Answer 1

The head tilt-chin lift is accomplished by tilting the head back on the atlanto-occipital joint while keeping the mouth closed. This clears the tongue and opens the airway. Jaw thrust also removes the tongue from the back of the throat, and is more suitable in pts with spinal precautions.

Question 2

Safely prepare patient and
equipment for endotracheal
intubation

Answer 2

• BVM
• Airway adjuncts
• Ventilator
• CO2 monitor
• multiple size ETTs
• Airway adjuncts
• lube
• string
• tape
• 10ml syringe for balloon
• laryngoscope (?video)
• pre-oxygenation equipment
• advanced airway trolley
• medications for paralysis and induction

Question 3

Assist with endotracheal

intubation

Answer 3

• Preparation
• Pre-oxygenation
• Pre-treatment
• Paralysis with
induction
• Positioning
• Placement with proof
• Post-intubation
management

Question 4

Demonstrate correct
technique in the application
of cricoid pressure

Answer 4

• Identify cricoid cartilage (C6 level, find thyroid cartilage and move inferiorly to find cricothyroid membrane)
• place index finger over cartilage then place thumb and middle finger on either side apply moderate pressure
• keep pressure applied until tracheal intubated, cuff inflated and both lung are being ventilated
• this provides oesophageal compression preventing passive regurgitation

Question 5

Demonstrate correct
technique for securing the
endotracheal tube (ETT)

Answer 5

.

Question 6

Demonstrate correct
technique for suctioning of
the ETT or tracheostomy

Answer 6

• identify indication
• Ensure suction does not exceed the length of the ETT/Tracheostomy
• Don gloves
• Insert inline suction
• hold ETT and head to avoid accidental extubation
• Apply negative pressure and twist in removal
• lavage suction tubing with sterile water if required

Question 7

Identify and locate at least 3
pieces of equipment used in
your department for difficult
intubation and explain their
function

Answer 7

• laryngoscope
• cricothyroidotomy set
• retrograde intubation kit

Question 8

Demonstrate post intubation

care

Answer 8

• Waveform Capnography
• Secure the Tube Well
• Confirm Lung Protective Vent Settings
• Achieve Adequate Analgesia and Sedation
• Raise the Head of the Bed to 30 – 45°
• Humidify the Air
• Place In-Line Suction
• Gastric Tube
• Cuff Pressure
• Nebulizers/MDI
• Prevent Aspiration past the Cuff of the ETT
• Get a Blood Gas
• Check Tube Depth
• Put a BVM at the Bedside
• Have a Plan for Vent Alarms
• Oral care

Question 9

Demonstrate the correct
technique for extubation of
the ETT

Answer 9

• prepare intubation trolley in case re-intubation required
• confirm order for extubation
• confirm patient ready for extubation
• pre-oxygenate patient
• suction ETT
• suction mouth
• remove tapes
• deflate cuff
• remove ETT
• apply oxygen via face mask