Advanced Airway Techniques / Cannulation

Question 1

3 Types of Advanced Airway

Answer 1

Supraglottic - IGEL
Surgical Cricothyroidotomy/ Surgical Airway
Endotracheal Intubation

Question 2

Contra-Indications of a Supraglottic Airway/IGEL

3

Answer 2

Gag reflex / conscious patient
Spontaneous Respirations
Significant Facial Trauma

Question 3

Indications for Surgical Cricothyroidotomy

Answer 3

Inability to ventilate
Inability to maintain Spo2 of more than 90%
Severe upper airway trauma

Question 4

Contra-Indications of Surgical Cricothyroidotomoy- surgical airway
(3)

Answer 4

Unable to identify anatomical landmarks
Anatomical abnormality (laryngeal fracture
Ability to secure the airway with less invasive means

Question 5

Indications of Endotracheal Intubation

Answer 5

Non-Anaesthetic
Deeply unconscious casualty
Management of Cardiac Arrest
With Aesthetic
Definitive airway for casualty transfer
Pre-empt airway obstruction from facial or neck trauma
Management of head/chest injuries

Question 6

Contra-Indications of an Endotracheal Intubation

Answer 6

Conscious patients

Trismus (lock jaw)

Difficult due to trauma, body shape or pre-existing disease (dependent on level of expertise)

Question 7

Potential complications of advanced airways

Answer 7

Hypoxia
Failed simple airway placement
Spinal cord injury
Damage to mouth, teeth or Larynx
Laryngeal spasm
Oesophageal intubation
Intubation of right bronchus only

Question 8

Definition of an IV cannula

Answer 8

A device that is inserted into a peripheral vein to take a blood sample or administrations of fluids and/or drugs

Question 9

Indications of an IV cannula

Answer 9

Short term therapy of less than a week – IV ABX, Fluids, Blood Transfusion

Bolus injections or short infusions – Drugs

Emergency Access

Question 10

With an IV cannula, what are the sights or indications you would avoid

Answer 10

Veins in the lower extremities
Points of flexion (wrists and elbows)
Veins close to arteries
Small visible superficial veins
Veins irritated from previous use
Limbs affected by a clinical condition (oedema, stroke, mastectomy)
Infected sites
Broken skin

Question 11

Describe the process of flushing with an IV cannula

Answer 11

10mls of 0.9% sodium chloride must be administered via a 10ml syringe after administration of the cannula

If giving a IV drug through the cannula 0.9% of sodium chloride must be administered before and after administration

Always check the date of the sodium chloride

Question 12

Types of IV fluids

2

Answer 12

Crystalloid fluids – solutions of small molecules of water (e.g, sodium chloride, glucose, Hartmann’s)

Colloid fluids – Blood products

Question 13

Potential risks of IV cannulation / infusion

Answer 13

Haemorrhage/haematoma
Perforation of veins
Cannulation of an artery
Infiltration/extravasation – The inadvertent administration of solution into the surrounding tissue, instead of the intended vascular pathway
Shear
Infection/phlebitis – Inflammation of the intima lining of the vein
Air embolism – Air introduced into the vascular system
Local/systemic infection

Question 14

When selecting an IV cannula, what are the sights to use/indications

Answer 14

Distal veins first above previous sites
Easily palpable veins
Veins in the non-dominant side
Veins opposite to surgical procedure
Veins with the largest diameter
Undertake a thorough assessment to locate a suitable vein