Airway Management

Question 1

How do you correctly perform a Mallampati exam?

Answer 1

Sit upright
Extend the neck
Open the mouth wide
Stick out the tongue
DO NOT PHONATE

Question 2

What structures are seen with each Mallampati score?

Answer 2

Question 3

Which congenital disease are associated with cervical spine abnormalities?

Answer 3

“Kids Try Gold”
Klippel Feil
Trisomy 21
Goldenhar

Question 4

What are the three causes of angioedema?

Answer 4

1. Anaphylaxis
2. ACE Inhibitors
3. C1 esterase deficiency

Question 5

What is the treatment for angioedema caused by anaphylaxis?

Answer 5

Epinephrine
Antihistamines
Steroids

Question 6

Why do ACE inhibitors cause angioedema?

Answer 6

ACE inhibitors prevent the breakdown of bradykinin -> increased inflammatory response

Question 7

What is the treatment for angioedema caused by ACE inhibitors?

Answer 7

Icatibant
Ecallantide
FFP
C1 esterase

Question 8

What is the treatment for hereditary angioedema?

Answer 8

C1 esterase concentrate
FFP
Icatibant

Question 9

What is Ludwig’s Angina?

Answer 9

Cellulitis on the mouth floor due to bacterial infection

Question 10

What is the best approach to intubating someone with Ludwig’s Angina

Answer 10

Awake nasal intubation
OR
Awake Trach

Question 11

Which congenital conditions cause a big tongue?

Answer 11

“Big Tongue”
Beckwith
Trisomy 21

Question 12

Which congenital abnormalities cause an underdeveloped mandible?

Answer 12

“Please Get That Chin”
Pierre Robin
Goldenhar
Treacher Collins
Cri du Chat

Question 13

What are the airway characteristics of Pierre Robin?

Answer 13

Micrognathia
Glossoptosis (tongue that falls back and downward)
Cleft Palate

Question 14

What are the airway characteristics of Treacher Collins?

Answer 14

Question 15

What are the airway characteristics associated with Trisomy 21?

Answer 15

Question 16

What are the airway characteristics associated with Klippel Feil?

Answer 16

Fused cervical vertebrae

Question 17

What are the airway characteristics associated with Goldenhar?

Answer 17

Micrognathia
Cervical spine abnormalities

Question 18

What are the airway characteristics associated with Beckwith Syndrome?

Answer 18

Large tongue

Question 19

What are the airway characteristics associated with Cri du Chat?

Answer 19

Micrognathia
Laryngomalacia
Stridor

Question 20

What airway management technique is contraindicated in patients with Ludwig’s Angina?

Answer 20

Retrograde intubation

Could spread the infection

Question 21

The sniffing position consists of:

Answer 21

Cervical Flexion
Atlanto-Occipital Extension

Question 22

What is a Lefort 1 fracture?

Answer 22

Question 23

What is a Lefort 2 fracture?

Answer 23

Question 24

What is a Lefort 3 fracture?

Answer 24

Question 25

Where is the cribiform plate?

Answer 25

Question 26

Name three fractures that lead to cribiform plate injury

Answer 26

Lefort 2 Lefort 3 Basilar

Question 27

Tracheal cuff pressure should never exceed _____cm H20

Answer 27

25

Question 28

What are the benefits of a low volume high pressure cuff?

Answer 28

Better protection against aspiration Lower incidence of sore throat Easier visualization during intubation

Question 29

Which types of tubes have low volume high pressure cuffs?

Answer 29

Red rubber tubes Bronchial blockers Fastrachs

Question 30

How do you measure the measure on a low volume high pressure cuff?

Answer 30

You can't

Question 31

What is the maximum cuff pressure for an LMA?

Answer 31

60

Question 32

How much air should be placed in an LMA 5 cuff?

Answer 32

40ml Its always the number -1 x 10 LMA 3 = 20 LMA 4 = 30

Question 33

Answer 33

LMA C Trach

Question 34

Answer 34

Question 35

Answer 35

Question 36

What should you do if you see gastric secretions in the LMA?

Answer 36

Question 37

Answer 37

Combitube

Question 38

How is a combitube placed?

Answer 38

1. Blindly inserted 2. Inflate the proximal cuff (oropharyngeal) with 40-100 ml 3. Inflate the distal cuff (esophagus) with 10ml

Question 39

Answer 39

King

Question 40

Answer 40

Bullard

Question 41

What are the indications for a Bullard laryngoscope?

Answer 41

Question 42

Why would you ever use a Bullard instead of an FOB?

Answer 42

It's usually faster than fiberoptic, but the learning curve is high

Question 43

Can a Bullard be used in children?

Answer 43

Yes, it comes in pediatric sizes

Question 44

What are disadvantages to using a lighted stylet?

Answer 44

Difficult in patients with a thick, short neck Not useful in an emergency Should not be used in epiglottitis, tumor, swelling etc.

Question 45

What are the benefits to using a lighted stylet?

Answer 45

Question 46

What are indications for retrograde intubation?

Answer 46

Unstable cervical spine Upper airway bleeding Failed awake intubation

Question 47

What is an absolute contraindication to jet ventilation through a needle?

Answer 47

Upper airway obstruction, because exhalation is passive and cannot pass through the needle