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EM/Surg > Airway Emergencies (Exam #1) > Flashcards

Airway Emergencies (Exam #1) Flashcards

1
Q

What are the two types of Airway Obstruction? How can they progress?

A

Partial vs. Complete

- Partial → complete → respiratory arrest

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2
Q

What is the most common cause of airway obstruction?

A

Tongue

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3
Q

What is the time from complete airway obstruction to brain damage?

A

About 4 minutes

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4
Q

What are the two types of oxygen delivery device, and what is the capacity of each? What are the three subtypes of each?

A

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
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5
Q

What are the three types of airways?

A
  • Oral
  • Nasal
  • Laryngeal mask
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6
Q

What is the primary symptom seen with FB in toddlers? What two other signs/sxs may be seen?

A

Unilateral wheezing

  • Persistent cough
  • Decreased breath sounds
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7
Q

With trauma, what is the first step in assessing a patient? What are the next two steps?

A

Airway

  • BP
  • Circulation
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8
Q

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?

A

I, II and III

  • Type I = maxillary
  • Types II and III = cribriform fracture
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9
Q

What two types of Le Fort fracture are associated with cribriform fracture, and what type of airway should NOT be used?

A

Types II and III

- NO nasal airways

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10
Q

What three findings may be seen with Basilar Skull Fractures?

A
  • Battle’s sign
  • Raccoon eyes
  • CSF from ears or nose
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11
Q

What two complications can be seen with Anaphylaxis/Acute Allergic Reaction?

A
  • Respiratory compromise

- CV collapse

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12
Q

What are three physiologic results of Anaphylaxis/Acute Allergic Reaction?

A
  • Vasodilation
  • Bronchial constriction
  • Increase mucous gland secretions
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13
Q

What two pathophysiology components are associated with Anaphylaxis/Acute Allergic Reaction?

A
  • Antigen-Ab binds to mast cells

- IgE-mediated histamine release

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14
Q

What are the two possible causes of Angioedema, and what is an example of each?

A
  • Hereditary: insufficiency C1-esterase inhibitor synthesis

- Acquired: ACE-I

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15
Q

What medication should be administered to treat hereditary Angioedema? What is the primary cause of hereditary Angioedema?

A

Danazol

- Insufficiency C1-esterase inhibitor synthesis

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16
Q

What four medications can be administered to treat Anaphylaxis/Acute Allergic Reaction?

A
  • Epi
  • Antihistamines
  • B2 Agonists (albuterol)
  • Steroids
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17
Q

What are the two routes of administration of Epi, and which is preferred? What is the dosing of each?

A
  • IV + fluids (0.3-0.5 mg of 1:10,000)

- IM (0.3-0.5 mg of 1:1,000) = preferred

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18
Q

With Anaphylaxis/Acute Allergic Reaction, what two signs would induce the need for intubation?

A
  • Marked stridor

- Respiratory arrest

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19
Q

What condition involves bilateral, rapidly spreading submandibular cellulitis? What two symptoms are seen with this condition?

A

Ludwig’s Angina

  • Elevated tongue
  • Hard/firm induration of floor of mouth
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20
Q

What condition involves elevated tongue, hard/firm induration of floor of mouth, perioral edema, pain, trismus?

A

Ludwig’s Angina

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21
Q

What condition may be caused by mixed G- and anaerobic bacteria, tonsillitis, otitis media, pharyngeal trauma?

A

Retropharyngeal Abscess

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22
Q

What are the two primary symptoms of Retropharyngeal Abscess? What other two sxs may be seen?

A
  • Odynophagia
  • Drooling

Also fever or neck swelling

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23
Q

What condition is often seen in age 2-7 years; due to Hib?

A

Epiglottitis

24
Q

What condition involves abrupt toxic-appearing, fever, stridor, dysphagia, odynophagia, drooling, tripod position, cyanosis?

A

Epiglottitis

25
Q

What three symptoms are often seen with Epiglottitis?

A
  • Odynophagia
  • Drooling
  • Tripod position
26
Q

What condition involves “thumb sign” on XR?

A

Epiglottitis

27
Q

What finding can be seen with Epiglottitis?

A

“Thumb sign”

28
Q

What condition involves IMMEDIATE airway management; likely need surgery then abx? What abx is recommended?

A

Epiglottitis

- Ceftriaxone

29
Q

What condition is often benign, self-limited tracheal inflammation?

A

Croup

30
Q

What are the two most common etiologies of Croup?

A
  • Parainfluenza

- RSV

31
Q

What condition involves -3-day history of URI then “barking seal” cough (at night)?

A

Croup

32
Q

What condition involves “steeple sign” on XR?

A

Croup

33
Q

What finding can be seen with Croup?

A

“Steeple sign”

34
Q

What two medications are recommended to treat Croup?

A
  • Nebulized Epi

- Steroids (Prednisolone 1mg/kg vs. Decadron)

35
Q

What two populations are at highest risk of contracting Whooping Cough?

A
  • Unvaccinated infants

- Unvaccinated toddlers

36
Q

What triad of symptoms is associated with Whooping Cough?

A
  • Paroxysms of cough
  • Inspiratory stridor
  • Post-tussive vomiting
37
Q

What is the gold standard test used to evaluate Whooping Cough?

A

Nasopharyngeal swab on special culture media

38
Q

What is the recommended tx for Whooping Cough (2)? Who else should be treated?

A

Treat patient AND unprotected contacts

  • Erythromycin
  • Azithromycin
39
Q

What condition is more common in male infants 0-2 years?

A

Bronchiolitis

40
Q

What is the most common cause of Bronchiolitis?

A

RSV

41
Q

What three sxs are seen with Bronchiolitis?

A
  • Rapid respirations
  • Chest retractions
  • Wheezing
42
Q

What condition involves rapid respirations, chest retractions and wheezing; runny nose, sneezing, low grade fever, SOB?

A

Bronchiolitis

43
Q

What is the recommended diagnosis of Bronchiolitis? What two other findings are indicative of Bronchiolitis?

A

CLINICAL

  • CXR shows hyperinflated lungs
  • Pulse ox shows hypoxia
44
Q

What are the three pathophysiology components of Asthma?

A
  • Paroxysmal attacks (reversible bronchospasm)
  • Mucous plug
  • Inflammation of tracheobronchial tree
45
Q

What three medications can be used to treat Asthma?

A
  • B2 Agonists = bronchodilators (Albuterol)
  • Steroids, PO vs. IV
  • Anticholinergics (Atrovent)
46
Q

For acute asthma exacerbation, what is the recommended tx (amount, type and administration)?

A

Stacked SVN treatments with bronchodilators

- 0.5 cc Albuterol in 2.5 cc normal saline, 3 treatments every 30 minutes

47
Q

What condition involves alveoli become filled with pus → air is excluded?

A

Pneumonia (PNA)

48
Q

What three treatments are recommended for PNA?

A
  • Abx
  • B2 Agonists
  • Analgesics (for fever)
49
Q

What condition involves air enters pleural cavity → lung collapse?

A

Pneumothorax (PTX)

50
Q

What two symptoms are often seen with Pneumothorax (PTX)?

A
  • CP on ipsilateral side

- SOB

51
Q

What condition involves tracheal deviation to opposite side?

A

Tension PTX

52
Q

What condition involves US shows “barcode” sign?

A

Pneumothorax (PTX)

53
Q

What US finding is seen with PTX?

A

“Barcode” sign

54
Q

With treatment of Pneumothorax (PTX), what is recommended if <20% involvement on CXR? What if 20+%?

A
  • <20%: observe

- 20+%: intervention

55
Q

What two treatment options are considered for Pneumothorax (PTX), and which is specific to Tension PTX?

A
  • Tube Thoracostomy (chest tube)

- Needle Decompression if Tension PTX

56
Q

What is the proper technique for Needle Decompression, and what condition is it used to treat?

A

Tension PTX

- Mid axillary incision at 5th interspace, tunnel to 4th rib

EM/Surg (16 decks)

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