Airway Management

Question 1

Indications for SGA placement

Answer 1

Patients unable to protect their airway due to DLOC

Question 2

Indications for Intubation

Answer 2

Airway - Protect, maintain, obtain a patent airway.
Breathing - oxygenation or ventilation
Predicted clinical course

Question 3

Ways to maximize first pass success

Answer 3

• CRM

- Setup

Question 4

Intubation set up - preparation phase

Answer 4

• PPE
• Establish roles - intubator , helper - ELM, bougie
• Establish goals
• Induction Plan and confirm dosing
• medication drawn and ready
• rescue plan

Question 5

Intubation set up - patient preparation

Answer 5

• Optimize hemodynamics - fluid/vasopressors MAP >65
• Pre-oxygenate and HFNO
• ECG, SpO2, EtO2, NIBP q 3 min
• Vascular access x 2
• Position patient

Question 6

Intubation set up - equipment

Answer 6

BVM with PEEP Valve & Attached to O2
Laryngoscope & Blades Tested
Consider VL & Test Device
Suction Tested AND Under Patient's Right Shoulder
ET Tube(s) - Syringe, Verify Cuff & Lubrication
Bougie - Out & Ready
ETT Securing Device
SGA Readily Available
Front of Neck Access (FONA)

Question 7

Post Intubation check list - confirmation

Answer 7

EtCO2 Value AND Waveform
Bilateral Auscultation
Negative Epigastric Auscultation
Note Tube Depth

Question 8

Post Intubation Checklist - Ongoing care

Answer 8

BP Q 3mins
Consider Ongoing Sedation
Consider Tracheal Suctioning
Consider Gastric Tube
Optimize Venous Drainage (Collar, Tube Ties, Etc.)
Head of Bed at 30 Degrees
Check Cuff Pressure
Consider PEEP - Start at 5cmH20
Document at End of Call