Airway management

Question 1

Which of these airways assessments consider how far the lower incisors can be protruded in front of the upper incisors?

Answer 1

Mandibular protrusion test

Question 2

In which Cormac-Lehane grade can only the epiglottis be observed?

Answer 2

Grade 3

Question 3

What is the name of the side opening on the distal tip of an endotracheal tube?

Answer 3

Murphy’s eye

Question 4

Pin Index Safety System of oxygen

Answer 4

2 & 5

Question 5

Pin Index Safety System of nitrous oxide

Answer 5

3 & 5

Question 6

Piped outlet colour code of nitrous oxide

Answer 6

Blue

Question 7

Pin Index Safety System of medical air

Answer 7

1 & 5

Question 8

Medical air is usually used in anaesthesia as:

Answer 8

A carrier gas for volatile anaesthetic agents.

Question 9

Piped outlet colour code of medical air

Answer 9

White and black quartered

Question 10

Composition of entonox

Answer 10

50% oxygen & 50% nitrous oxide

Question 11

Pin Index Safety System of entonox

Answer 11

7

Question 12

Composition of heliox

Answer 12

21% oxygen & 79% helium

Question 13

Cylinder colour code of heliox

Answer 13

White with brown and white shoulder quartering

Question 14

Piped outlet colour code of entonox

Answer 14

Can be either blue or white (So great care must be taken to avoid incorrect connection to either O2 or N2O)

Question 15

Oxidisation warning label symbol

Answer 15

Circle on fire

Question 16

Storage Pressure warning label symbol

Answer 16

Sideways cylinder

Question 17

Storage pressure in a medical gas cylinder can be up to:

Answer 17

300 bar

Question 18

Temperature warning label symbol

Answer 18

Snowflake along with temperature

Question 19

Ability to Asphyxiate warning label symbol

Answer 19

Sad man

Question 20

Why are anaesthetic circuits designed to minimise rebreathing?

Answer 20

It can cause serious elevations in blood CO2 levels.

Question 21

What are the advantages of inhalation induction? (8 in total)

Answer 21

• Less traumatic
• Allows induction where venous access is difficult
• Spontaneous ventilation
• Airway tone better maintained
• Depth of anaesthesia can be controlled
• No risk of acute anaphylaxis
• Bronchodilator effect
• Brief outpatient anaesthesia effect

Question 22

What are the disadvantages and risks of inhalation induction? (8 in total)

Answer 22

• Smell of agent
• Airway irritation
• Traumatic second stage of anaesthesia
• Cardiovascular and respiratory depression
• Delayed definitive airway control
• Theatre pollution
• Malignant hyperthermia
• Emergence issues (such as delirium)

Question 23

What are the advantages of intravenous (IV) anaesthesia? (4 in total)

Answer 23

• A faster/ cleaner recovery for short cases
• Less post-operative nausea and vomiting
• Less contamination from greenhouse gases than inhalational anaesthetics
• No risk of malignant hyperthermia

Question 24

What are the disadvantages of intravenous (IV) anaesthesia? (4 in total)

Answer 24

• Unidentified disconnection or extravasation (tissuing) of the propofol infusion can lead to awareness.
• Extra equipment, training and setup are needed.
• Recovery can be slow after very long operations.
• All concentrations whether it be plasma or effect site are estimates made by the pump programme

Question 25

What drugs are used for TIVA?

Answer 25

Propofol 1% and Remifentanil, although Alfentanil can also be used.

Question 26

What drug characteristics are best for TIVA?

Answer 26

Fast onset and recovery

Question 27

At which pressure will an adjustable pressure limiting (APL) valve open?

Answer 27

60cmH20

Question 28

What is a contraindication for insertion of an oropharyngeal airway?

Answer 28

Semi-conscious patient with active gag reflex