Airway Emergencies (Exam #1) Flashcards
What are the two types of Airway Obstruction? How can they progress?
Partial vs. Complete
- Partial → complete → respiratory arrest
What is the most common cause of airway obstruction?
Tongue
What is the time from complete airway obstruction to brain damage?
About 4 minutes
What are the two types of oxygen delivery device, and what is the capacity of each? What are the three subtypes of each?
Low-Flow = 2-8 L
- Nasal cannula
- Simple, partial rebreathing mask
- Mask with reservoir bag vs. resuscitation bags (AMBU)
High-Flow = up to 40 L
- Aerosol masks
- T-pieces
- Venture masks
What are the three types of airways?
- Oral
- Nasal
- Laryngeal mask
What is the primary symptom seen with FB in toddlers? What two other signs/sxs may be seen?
Unilateral wheezing
- Persistent cough
- Decreased breath sounds
With trauma, what is the first step in assessing a patient? What are the next two steps?
Airway
- BP
- Circulation
What are the three types of Le Fort fractures? Which type involves maxillary fracture? What type of fracture is often associated with the other two types?
I, II and III
- Type I = maxillary
- Types II and III = cribriform fracture
What two types of Le Fort fracture are associated with cribriform fracture, and what type of airway should NOT be used?
Types II and III
- NO nasal airways
What three findings may be seen with Basilar Skull Fractures?
- Battle’s sign
- Raccoon eyes
- CSF from ears or nose
What two complications can be seen with Anaphylaxis/Acute Allergic Reaction?
- Respiratory compromise
- CV collapse
What are three physiologic results of Anaphylaxis/Acute Allergic Reaction?
- Vasodilation
- Bronchial constriction
- Increase mucous gland secretions
What two pathophysiology components are associated with Anaphylaxis/Acute Allergic Reaction?
- Antigen-Ab binds to mast cells
- IgE-mediated histamine release
What are the two possible causes of Angioedema, and what is an example of each?
- Hereditary: insufficiency C1-esterase inhibitor synthesis
- Acquired: ACE-I
What medication should be administered to treat hereditary Angioedema? What is the primary cause of hereditary Angioedema?
Danazol
- Insufficiency C1-esterase inhibitor synthesis
What four medications can be administered to treat Anaphylaxis/Acute Allergic Reaction?
- Epi
- Antihistamines
- B2 Agonists (albuterol)
- Steroids
What are the two routes of administration of Epi, and which is preferred? What is the dosing of each?
- IV + fluids (0.3-0.5 mg of 1:10,000)
- IM (0.3-0.5 mg of 1:1,000) = preferred
With Anaphylaxis/Acute Allergic Reaction, what two signs would induce the need for intubation?
- Marked stridor
- Respiratory arrest
What condition involves bilateral, rapidly spreading submandibular cellulitis? What two symptoms are seen with this condition?
Ludwig’s Angina
- Elevated tongue
- Hard/firm induration of floor of mouth
What condition involves elevated tongue, hard/firm induration of floor of mouth, perioral edema, pain, trismus?
Ludwig’s Angina
What condition may be caused by mixed G- and anaerobic bacteria, tonsillitis, otitis media, pharyngeal trauma?
Retropharyngeal Abscess
What are the two primary symptoms of Retropharyngeal Abscess? What other two sxs may be seen?
- Odynophagia
- Drooling
Also fever or neck swelling
What condition is often seen in age 2-7 years; due to Hib?
Epiglottitis
What condition involves abrupt toxic-appearing, fever, stridor, dysphagia, odynophagia, drooling, tripod position, cyanosis?
Epiglottitis
What three symptoms are often seen with Epiglottitis?
- Odynophagia
- Drooling
- Tripod position
What condition involves “thumb sign” on XR?
Epiglottitis
What finding can be seen with Epiglottitis?
“Thumb sign”
What condition involves IMMEDIATE airway management; likely need surgery then abx? What abx is recommended?
Epiglottitis
- Ceftriaxone
What condition is often benign, self-limited tracheal inflammation?
Croup
What are the two most common etiologies of Croup?
- Parainfluenza
- RSV
What condition involves -3-day history of URI then “barking seal” cough (at night)?
Croup
What condition involves “steeple sign” on XR?
Croup
What finding can be seen with Croup?
“Steeple sign”
What two medications are recommended to treat Croup?
- Nebulized Epi
- Steroids (Prednisolone 1mg/kg vs. Decadron)
What two populations are at highest risk of contracting Whooping Cough?
- Unvaccinated infants
- Unvaccinated toddlers
What triad of symptoms is associated with Whooping Cough?
- Paroxysms of cough
- Inspiratory stridor
- Post-tussive vomiting
What is the gold standard test used to evaluate Whooping Cough?
Nasopharyngeal swab on special culture media
What is the recommended tx for Whooping Cough (2)? Who else should be treated?
Treat patient AND unprotected contacts
- Erythromycin
- Azithromycin
What condition is more common in male infants 0-2 years?
Bronchiolitis
What is the most common cause of Bronchiolitis?
RSV
What three sxs are seen with Bronchiolitis?
- Rapid respirations
- Chest retractions
- Wheezing
What condition involves rapid respirations, chest retractions and wheezing; runny nose, sneezing, low grade fever, SOB?
Bronchiolitis
What is the recommended diagnosis of Bronchiolitis? What two other findings are indicative of Bronchiolitis?
CLINICAL
- CXR shows hyperinflated lungs
- Pulse ox shows hypoxia
What are the three pathophysiology components of Asthma?
- Paroxysmal attacks (reversible bronchospasm)
- Mucous plug
- Inflammation of tracheobronchial tree
What three medications can be used to treat Asthma?
- B2 Agonists = bronchodilators (Albuterol)
- Steroids, PO vs. IV
- Anticholinergics (Atrovent)
For acute asthma exacerbation, what is the recommended tx (amount, type and administration)?
Stacked SVN treatments with bronchodilators
- 0.5 cc Albuterol in 2.5 cc normal saline, 3 treatments every 30 minutes
What condition involves alveoli become filled with pus → air is excluded?
Pneumonia (PNA)
What three treatments are recommended for PNA?
- Abx
- B2 Agonists
- Analgesics (for fever)
What condition involves air enters pleural cavity → lung collapse?
Pneumothorax (PTX)
What two symptoms are often seen with Pneumothorax (PTX)?
- CP on ipsilateral side
- SOB
What condition involves tracheal deviation to opposite side?
Tension PTX
What condition involves US shows “barcode” sign?
Pneumothorax (PTX)
What US finding is seen with PTX?
“Barcode” sign
With treatment of Pneumothorax (PTX), what is recommended if <20% involvement on CXR? What if 20+%?
- <20%: observe
- 20+%: intervention
What two treatment options are considered for Pneumothorax (PTX), and which is specific to Tension PTX?
- Tube Thoracostomy (chest tube)
- Needle Decompression if Tension PTX
What is the proper technique for Needle Decompression, and what condition is it used to treat?
Tension PTX
- Mid axillary incision at 5th interspace, tunnel to 4th rib
