Airway

Question 0

3-3-2-1

Answer 0

3 fingers in the mouth vertically
3 fingers on bottom of chin from tip to
2 fingers between Larynx and base of jaw
1 finger between upper and lower teeth with saw displaced forward

Question 1

LEMON

Answer 1

Look
Evaluate 3-3-2-1
Mallampati
Obstructions
Neck Mobility

Question 2

Cormac Lehane

Answer 2

1-vocal cords glottic opening visible
2-artyenoid cartilages visible
3-Tip of epiglottis
4-epiglottis not visible

Question 3

Mallampati

Answer 3

1-columns present
2-uvula and tops of columns
3-bass of uvula
4-soft palate only cannot see uvula

Question 4

7 P’s

Answer 4

Preparation, pre-oxygenation, premedication, paralysis with induction, protection and positioning, placement and proofing of ETT, post intubation management

Question 5

SODA & LOAD

Answer 5

Suction, oxygen, drugs, airways

Lidocaine, opioids, atropine, defasciculating

Question 6

Functional residual capacity is what percentage of nitrogen and oxygen

Answer 6

Nitrogen 78%, oxygen 21%

Question 7

How many sonometers of water are required to ventilate the gastric cavity

Answer 7

20

Question 8

Actions of lidocaine during premedication

Answer 8

CNS depressant, limits bronchospasm and ICP spikes (debatable), can prevent laryngospasm

Question 9

Two reasons atropine is given to premedication for pediatric patients

Answer 9

1. Hyper vagal system. Delayed sympathetic nervous system development until about 4 to 8 years old. Bradycardia
   - Succ can cause bradycardia
2. Kids have juicy airways. Especially consider when ketamine is used for induction

Question 10

Do you fasciculation agents why are they used?

Answer 10

• Prevent fasciculations and in theory The large release of potassium.
• prevent myalgia and soreness in muscles
• prevents Intragastric, intraocular, and ICP spikes

Question 11

What is the most appropriate positioning for intubation

Answer 11

Head lifted 5 to 10 cm for optimal sniffing position and visualization, want to ear canals lined up with the frontal plane of the chest

Question 12

The burp maneuver should be used in caution with what population

Answer 12

Elderly and children as it may cause a vagal response

Question 13

Appropriate oral and nasal ETT depth

Answer 13

Oral: diameter of tube ×3
Nasal: diameter of tube times 4

Question 14

Primary versus secondary proofing

Answer 14

Primary proofing: subjective assessment

Secondary proofing is an objective assessment

Question 15

State etomidate’s linear dosing relationship w/ LOC

Answer 15

For q .1mg/kg = 100 seconds of LOC

Question 16

Succ onset / duration

Answer 16

Onset: 30-60 seconds
Duration: 3-4 min (80%) 9-13 min (95%)

80% - will start breathing again
95% - mass ether control, eyelid twitching

Question 17

Succ. Commonly exhibits bradydysrhythmias VTVF w/ what?

Answer 17

Potassium disorders and on second dose

Question 18

ACh upregulation and Succ

Answer 18

Nerve damage- muscle tissue lacks signals. increases ach receptors, immature. Succ causes these receptors to open & stay open. Huge potassium shifts

Question 19

MH cause

Answer 19

Inherited genetic mutation of ryanodine receptor on sarcoplasmic reticulum (where Ca is stored)
These open & stay open on Succ administration.

Question 20

MH s/s

Answer 20

1: increasing ETCO2 then tachycardia, arrhythmias, cardiac arrest, muscle rigidity, messeter spasm, profound acidosis, hyperkalemia, elevated temp, myoglobinuria, DIC