Airway Management Flashcards
How do you correctly perform a Mallampati exam?
Sit upright
Extend the neck
Open the mouth wide
Stick out the tongue
DO NOT PHONATE
What structures are seen with each Mallampati score?
Which congenital disease are associated with cervical spine abnormalities?
“Kids Try Gold”
Klippel Feil
Trisomy 21
Goldenhar
What are the three causes of angioedema?
- Anaphylaxis
- ACE Inhibitors
- C1 esterase deficiency
What is the treatment for angioedema caused by anaphylaxis?
Epinephrine
Antihistamines
Steroids
Why do ACE inhibitors cause angioedema?
ACE inhibitors prevent the breakdown of bradykinin -> increased inflammatory response
What is the treatment for angioedema caused by ACE inhibitors?
Icatibant
Ecallantide
FFP
C1 esterase
What is the treatment for hereditary angioedema?
C1 esterase concentrate
FFP
Icatibant
What is Ludwig’s Angina?
Cellulitis on the mouth floor due to bacterial infection
What is the best approach to intubating someone with Ludwig’s Angina
Awake nasal intubation
OR
Awake Trach
Which congenital conditions cause a big tongue?
“Big Tongue”
Beckwith
Trisomy 21
Which congenital abnormalities cause an underdeveloped mandible?
“Please Get That Chin”
Pierre Robin
Goldenhar
Treacher Collins
Cri du Chat
What are the airway characteristics of Pierre Robin?
Micrognathia
Glossoptosis (tongue that falls back and downward)
Cleft Palate
What are the airway characteristics of Treacher Collins?
What are the airway characteristics associated with Trisomy 21?
What are the airway characteristics associated with Klippel Feil?
Fused cervical vertebrae
What are the airway characteristics associated with Goldenhar?
Micrognathia
Cervical spine abnormalities
What are the airway characteristics associated with Beckwith Syndrome?
Large tongue
What are the airway characteristics associated with Cri du Chat?
Micrognathia
Laryngomalacia
Stridor
What airway management technique is contraindicated in patients with Ludwig’s Angina?
Retrograde intubation
Could spread the infection
The sniffing position consists of:
Cervical Flexion
Atlanto-Occipital Extension
What is a Lefort 1 fracture?
What is a Lefort 2 fracture?
What is a Lefort 3 fracture?
Where is the cribiform plate?
Name three fractures that lead to cribiform plate injury
Lefort 2
Lefort 3
Basilar
Tracheal cuff pressure should never exceed _____cm H20
25
What are the benefits of a low volume high pressure cuff?
Better protection against aspiration
Lower incidence of sore throat
Easier visualization during intubation
Which types of tubes have low volume high pressure cuffs?
Red rubber tubes
Bronchial blockers
Fastrachs
How do you measure the measure on a low volume high pressure cuff?
You can’t
What is the maximum cuff pressure for an LMA?
60
How much air should be placed in an LMA 5 cuff?
40ml
Its always the number -1 x 10
LMA 3 = 20
LMA 4 = 30
LMA C Trach
What should you do if you see gastric secretions in the LMA?
Combitube
How is a combitube placed?
- Blindly inserted
- Inflate the proximal cuff (oropharyngeal) with 40-100 ml
- Inflate the distal cuff (esophagus) with 10ml
King
Bullard
What are the indications for a Bullard laryngoscope?
Why would you ever use a Bullard instead of an FOB?
It’s usually faster than fiberoptic, but the learning curve is high
Can a Bullard be used in children?
Yes, it comes in pediatric sizes
What are disadvantages to using a lighted stylet?
Difficult in patients with a thick, short neck
Not useful in an emergency
Should not be used in epiglottitis, tumor, swelling etc.
What are the benefits to using a lighted stylet?
What are indications for retrograde intubation?
Unstable cervical spine
Upper airway bleeding
Failed awake intubation
What is an absolute contraindication to jet ventilation through a needle?
Upper airway obstruction, because exhalation is passive and cannot pass through the needle
