Airway Flashcards
How many classes are there in the Mallampati score?
4
Describe the 4 classes of Mallampati score
Class 1: Soft palate, uvula, fauces, pillars
Class 2: Soft palate, uvula, fauces
Class 3: Soft palate, base of uvula visible
Class 4: Only hard plate visible
What is the classification for views of glottis during laryngoscopy?
The cormack-lehane classification
What are the 4 grades of the Cormack-Lehane Classification?
Grade 1: Full view of glottis
Grade 2: Partial view of glottis, only posterior extremity of glottis seen or only arytenoid cartilages
Grade 3: Only epiglottis seen
Grade 4: Neither glottis nor epiglottis seen
What length at the lips should an ETT be for male and female adults?
Male: 22-24cm
Female: 20-22cm
What type of ETT is used for adults?
Cuffed Parker Flexi-Tip
9.0 - adult male
8.0 - adult male/female
7.0 - adult female
6.0 - large child
What type of ETT is used for paediatrics?
Microcuff
5.5 - 8-10yo
5.0 - 6-8yo
4.5 - 4-6yo
4.0 - 2-4yo
3.5 - 8mo-2yo
What type of ETT is used to pre-term infants?
Coviden Cuffless
2.5 - appropriate pre-term infants
What type of bougie is used for intubation?
Frova 14Fr intubating catheter
Used for adult and large child intubation
Do you use a bougie or stylet for intubation paediatrics?
Stylet
10Fr intubating stylet for ETT sizes 4.5 - 5.5
6Fr intubating stylet for ETT sizes 2.5 - 4.0
What are the indications for oral endotracheal intubation?
Actual loss of airway patency and/or airway protection
What are the contraindications for oral endotracheal intubation?
Conscious breathing patients
What are the 7 complications of oral endotracheal intubation?
Unrecognised oesophageal insertion
Malposition
Aspiration
Hypoxia
Laryngospasm
Oropharyngeal trauma
Vagal nerve stimulation
When using an intubating catheter or boogie, what can indicate you are in the trachea?
Clicking of the tracheal rings and hold up when the boogie contacts the carina
How do you align the airway axes in adults and paediatrics?
Adults - elevate the head (“ramping”)
Older child - extension of the head
Small child - slight extension of the head
Infant - slight elevation of the shoulders
What are the sizes of LMA for weight groups?
1: Neonate 2 - 5kg
1.5: Infant 5 - 12kg
2: Small paediatric 10-25kg
2.5: Large paediatric 25-35kg
3: small adult 30-60kg
4: Medium adult 50-90kg
5: Large adult >90kg
What are the indications for LMA?
Actual loss of airway patency and/or airway protection
What are the 2 contraindications for LMA?
Conscious breathing patients
Continuous use for >4 hours
What are the 5 complications of LMA insertion?
Failure to provide adequate airway or ventilation
Patient intolerance
Hypoxia
Can precipitate vomiting and aspiration in a patient with intact airway reflexes
Oropharyngeal trauma
What is the mnemonic for predicting difficult airways?
L - look - beard, dentures, missing teeth
E - Evaluate - 3-3-2
M - Mallampati score
O - Obstruction - foreign body, tumour, vomitus, haematoma
N - neck motility - able to touch chin to chest and hyperextend head/neck
What is the carina and where on the sternum does it lie behind?
The carina is where the trachea bifercates into the left and right main bronchus.
It is at the level of the angle of Louis
How long is the trachea?
The trachea is 10-13cm long
What are the landmarks for the triangle of safety?
Base of the axilla, lateral border of pectoralis major, anterior border of latissimus dorsi, nipple line/mammary fold.
Incision site is at 4th intercostal space anterior to the midaxilla lane
What technique does QAS use for surgical cricothyrotomy?
Scalpel bougie technique
What is the technique for cutting the cricothyroid membrane?
SERT
Stab (scalpel blade facing you)
Extend towards you as far as possible
Reverse
Turn scalpel towards feet
