Airway and Alertness

Question 1

What are the components of the primary assessment?

Answer 1

A, B. C, D and E

Question 2

What does “A” stand for?

Answer 2

A - airway and alertness

Question 3

How do you assesses for alertness?

Answer 3

A - alert
V - responds to verbal stimuli
P - responds to painful stimuli
U - unresponsive

Question 4

When will the pt be able to maintain his/her airway?

Answer 4

If pt is alert and airway is clear

Question 5

When should you consider the airway comprimised?

Answer 5

If pt responds to only verbal/pain stimuli or is unresponsive.

Question 6

Until when should you suspect a cervical spine injury (CSI)?

Answer 6

• until Glasgow Coma Scale Score is 15 and evaluated by physician
• cleared by radiography or CT

Question 7

How can the cervical spine alignment and protection be maintained?

Answer 7

• manual stabilization

- immobilization

Question 8

When do you remove the spine board?

Answer 8

when a spinal cord injury has been has been ruled out

Question 9

How do you remove a helmet?

Answer 9

• two people
• one person that provides manual stabilization
• one person that removes helmet

Question 10

How do you inspect an airway?

Answer 10

• alert - ask pt to open mouth
• if pt unable to open mouth, responds to verbal/painful stimuli or is unresponsive - suspect CSI and have two people perform the jaw-thrust procedure

Question 11

What do you inspect the airway for?

Answer 11

• tongue obstructing airway
• loose/missing teeth
• foreign object
• blood/vomit, secretions
• edema
• burns/evidence of inhalation injury

Question 12

What do you auscultate the airway for?

Answer 12

obstructive airway sounds - snoring, gurgling, stridor

Question 13

What do you palpate the airway for?

Answer 13

• maxillofacial bony deformity

- subcutaneous emphysema

Question 14

How do you assess for proper placement of the airway device?

Answer 14

• adequate rise/fall of chest with assisted ventillation
• absence or gurgling over epigastrum
• bilateral breath sounds
• presence of CO2 verified by CO2 detector

Question 15

What do you do after you assess/confirm placement of airway device?

Answer 15

move to next step of the primary survey

Question 16

What can the pt do if he/she is awake and airway is patent?

Answer 16

assume position to that facilitates breathing

Question 17

What do you do if the airway is not patent?

Answer 17

• suction airway
• airway adjunct (naso/oropharyngeal airway)
• definitive airway (endotracheal intubation)

Question 18

What do you not want to stimulate when suctioning?

Answer 18

gag reflex

Question 19

What type of device is used to suction blood, vomit or other secretions?

Answer 19

rigid suction device

Question 20

How do you remove a foreign body?

Answer 20

forceps or another appropriate method

Question 21

If suctioning does not relieve airway, what could be the cause of obstruction?

Answer 21

tongue

Question 22

What should you consider if airway is obstructed after suctioning?

Answer 22

nasopharyngeal or oropharyngeal airway

Question 23

When can a nasopharyngeal be used?

Answer 23

pt is conscious or unconscious

Question 24

When can a oropharyngeal be used?

Answer 24

pt is without a gag reflex

Question 25

What is a definitive airway?

Answer 25

a tracheal tube securely place in the trachea with the cuff inflated

Question 26

When do conditions/situations require a definitive airway?

Answer 26

• apnea
• GCS of 8 or less
• maxillofacial fx
• inhalation injury
• laryngeal/tracheal injury or neck hematoma
• high risk of aspiration
• compromised/ineffective ventillation
• anticipation that pt will be unable to maintain/protect their airway