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Junior Anaesthesia > Airway Management > Flashcards

Airway Management Flashcards

1
Q

Airway must remain patent to ensure adequate _________ and _____________

A

ventilation and oxygenation

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2
Q

Advanced airway placement ensures uninterrupted ___________ during ventilation in cardiac arrest

A

chest compression

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3
Q

Airway consists of ??

A

Nasal and oral cavities
Pharynx
Larynx
Trachea
Bronchi

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4
Q

METHODS OF AIRWAY MAINTENANCE

________________ airway devices
_________________ airway devices
____________ airways

A

Supraglottic (upper )

Infraglottic (lower)

Surgical

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5
Q

METHODS OF AIRWAY MAINTENANCE

Supraglottic (upper )airway devices – mention 3

Infraglottic (lower) airway devices – mention 3

Surgical airways – mention 2

A

oro/ naso-pharyngeal airway, laryngeal mask airway, i-gel

endotracheal tube, combitube, laryngeal tube

cricothyroidotomy ,tracheostomy

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6
Q

ORO-PHARYNGEAL AIRWAYS (OPA)
e.g Guedel’s airway

•____-shaped device
•Inserted through ______ into _____________
•_________ prevent airway from falling back into mouth
•_______ portion lies between teeth and prevent occlusion by biting

A

J; mouth; oropharynx

Flanges; Bite

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7
Q

Oro-pharyngeal airways

•Size from neonate to large adult
•Paediatrics-size _____ to _____
•Adult-size ____ to _____
•May cause ________ on insertion
•May stimulate ________ or _________ if patient is semi-conscious

A

000 to 2

3 to 5

trauma

gag reflex or vomiting

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8
Q

SIZING THE ORO -PHARYNGEAL AIRWAY

Angle of ———— to _______

Or

____________ to ______________

A

mouth to earlobe

Centre of incisor to angle of jaw

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9
Q

CAUTION WHEN USING OPA

Oro-pharyngeal airways that are too large may _______________ or ____________ to the airway

Oro-pharyngeal airways that are too small or inserted wrongly may ______________________________ and obstruct the airway

A

obstruct the larynx or cause trauma

push the base of the tongue posteriorly

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10
Q

Insertion of oro-pharyngeal airway

Open the mouth
Insert airway into oral cavity
Advance airway until _____________________

In _________- do not rotate in oral cavity!

A

it lies in the pharynx

children

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11
Q

INSERTION OF ORO-PHARYNGEAL AIRWAY

Open the mouth
Insert airway into oral cavity in the ____________ position as far as the __________________

Rotate it through ______ –minimises chance of ___________________________

Advance airway until it lies in the _______
Fits over tongue and pushes it away from ______________________

Correct placement- improvement in airway reflexes and sitting of bite portion b/w teeth

A

upside-down; junction between the hard and soft palate

1800; pushing tongue backwards and downwards

pharynx; post. pharyngeal wall

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12
Q

NASO-PHARYNGEAL AIRWAY

Inserted through the ______ into the ________

Bypasses the _________ and ___________

______________ inserted through flange to prevent migration into the nose

A

nose; nasopharynx

mouth and oropharynx

Safety-pin

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13
Q

Naso-Pharyngeal Airway

Contra-indicated in cases of ____________________
Life saving in __________,__________, or _____________ injuries

Caution in children with _________

A

fracture base of skull

clenched jaw, trismus or maxillofacial

adenoids

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14
Q

(Oro or Naso?) Pharyngeal Airway is Better tolerated by semi-conscious patients

A

Naso

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15
Q

SIZING OF NASO-PHARYNGEAL AIRWAY

_________________ to ___________________

Diameter should be equal or (smaller or larger?) than patients ____________

Compare the outer circumference of the naso- pharyngeal airway with the __________________________

A

Tip of the nose to the tip of the earlobe

Smaller; little finger

inner aperture of the nares

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16
Q

INSERTION OF NASO-PHARYNGEAL AIRWAY

Select appropriate size
___________ the nasopharyngeal airway
Insert the _________ end (vertically or horizontally?) along the _______ of the nose with a slight ________ action

The flange should rest against the nasal opening. Maintain head tilt using chin lift or jaw thrust.
Once in place use ______,_________, and ___________ technique to assess patency and adequacy of ventilation

A

Lubricate; bevel; vertically

floor; twisting

look, listen and feel

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17
Q

LARYNGEAL MASK AIRWAYS

Alternative to facemasks or tube Inserted through mouth so cuff lies __________________

From neonatal to large adult sizes

A

above larynx

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18
Q

Laryngeal mask airway Does not protect against aspiration

T/F

A

T

19
Q

Devices that are used to maintain the airway patency and provide ventilation by placing just above the glottis opening

They sit outside the __________ and provide a __________ means of gas tight airway

A

trachea; hands free

20
Q

The first commercially available supraglottic airway device was ______- Classic (1988)

A

LMA

21
Q

INDICATION for LMA

Alternative airway during ———- specially in ___________ procedures and ___________ or __________ procedures like radiation therapy, diagnostic and interventional radiology, endoscopy, ECT etc

Also used in _______________________ to secure the airway

A

GA; short surgical

Minor therapeutic or diagnostic

Cardiopulmonary resuscitation

22
Q

Indications for LMA

Essential part of difficult airway trolley

Primary airway device when urgent airway patency is required in __________ position as lesser time required to place LMA in the lateral position as against _________________ in this position

A

lateral

endotracheal intubation

23
Q

CONTRAINDICATION of LMA

Limited _____________ ( _______________ )

_________________ in pharynx, larynx and upper airway

Trismus, facial or upper airway trauma

Increase risk of ___________ – morbid obese, > 14 weeks pregnant, prior opiods medication, delayed gastric empting, acute abdominal or thoracic injury, history of GERD and hiatus hernia
Reduced lung compliance/increase work of breathing

A

mouth opening; <2 fingers

Local pathology; aspiration

24
Q

Advantages of LMA

Increased ___________________________

Less requirement of _________

Improved hemodynamic stability at induction and during emergence of anaesthesia

Minimal ______ and ______ changes during insertion

Increase airway _______

Lower frequency of _______ during emergence
Improved _______________ during emergence

A

speed and ease of placement

expertise; aspiration

IOP and ICP

tolerance; coughing

oxygen saturation

25
Q

Disadvantages of LMA

Inadequate ___________ ventilation

More chances of ________ of gastric content
____________
___________ compression and ________ damage

A

positive pressure

Aspiration; Sore throat

Vascular; nerve

26
Q

LARYNGEAL MASK AIRWAY INSERTION

Select LMA of appropriate size
(Flex or Extend?) neck and (flex or extend?) head
Hold LMA like a _______, insert into mouth.

Advance tip behind __________ until it reaches the posterior pharyngeal wall

Press mask backwards and downwards until resistance is felt at back of pharynx
Connect inflating syringe, inflate cuff - 40ml (size 5); 30ml (size 4)

A

Flex; extend ; pen

upper incisor

27
Q

I-GEL

___________airway device

airway device Made from ____, _____-like material
Easy to insert, cause reduced trauma
Bite-block on ______

Has a Narrow __________________ tube

A

Supraglottic

soft, gel

stem

oesophageal drain

28
Q

ProSEAL LMA

___________ , silicon made

Modifications; _____________ tube
_____________________ cuff
Reinforced airway tube
___________ bite block
Introducer
_______ seal pressure (35cm H20)

A

Reusable

oesophagea drain

Posterior inflatable

Integral; High

29
Q

LMA-Surpreme

________ Generation LMA

__________________ cuff, no ————- cuff
Oesophargeal drain tube, without ———
Preformed semi –rigid tube
_____________ to prevent obstruction
Pharyngeal seal of 26-30 cmH20

A

2ND

Large inflatable plastic; posterior

seal

Epiglottic fins

30
Q

COMBITUBE
(Single or Double?) lumen tube
Tube enters either _______ or _________

Tracheal channel has open ————
Oesophageal tube has _____ opening.

A

Double

trachea or oesophagus

distal end; no

31
Q

COMBITUBE

Oesophageal tube has small _____ cuff and large _______ cuff to be inflated within the ________.
Between the two cuffs are several _________ through which larynx is ventilated

A

distal; proximal

pharynx; small side holes

32
Q

ENDOTRACHEAL INTUBATION

Passage of a tube through the ____________ into the _________.
Conduit for ventilation
Definitive airway

A

nose or mouth; trachea

33
Q

Endotracheal intubation

Numerous indications – Respiratory insufficiency, severe head injury, cardiac arrest
Undertaken by ______ personnel only
Intubation attempts must not exceed __________
Intubation is not undertaken on the ______________!!

A

skilled

30 seconds

corridors of A&E

34
Q

Endotracheal intubation Protects against aspiration

T/F

A

T

35
Q

PREPARATION FOR INTUBATION
Tiltable trolley
_______ supply
_____________ bag, ________
_______ apparatus
___________, _________________ tubes – various sizes
Stethoscope
Assistant to apply _____________
Others – gloves, plaster, 20ml syringe

A

Oxygen; Self-inflating; face mask

Suction; Laryngoscope ; Endotracheal

cricoid pressure

36
Q

ENDOTRACHEAL INTUBATION
A - endotracheal tube (blue)
B - _________ tube with _________
C – trachea
D - oesophagus
SECURE THE ETT TO PREVENT DISLODGEMENT

A

cuff inflation; pilot balloon

37
Q

NASOTRACHEAL INTUBATION TECHNIQUE

Apply __________________________________ drops
____________ tube wall
Guide the tube slowly but firmly into the nasal passage, going (up or down?) from the nostril( to avoid the ______________________ ) and then backward and down into the _____________

Proceed with the procedure as an _________ intubation, guiding the tube through the ___________ with a magils forceps

A

vasoconstrictor nasal; Lubricate

Up; large inferior turbinate

nasopharynx; orotracheal

vocal cords

38
Q

Most serious complication of endo-tracheal intubation is ???

A

unrecognised oesophageal intubation

39
Q

NEEDLE CRICOTHYROTOMY PROCEDURE

Place supine, head extended Identify the __________
Puncture the membrane ________ in ________ with large bore intravenous cannula or ________________ attached to a syringe

_________________ confirms tracheal location
Angle cannula at ______and advance caudally into trachea. Remove needle. Confirm air aspiration
Attach cannnula to high pressure oxygen supply

A

cricothyroid membrane

vertically; midline

cricothyrotomy needle; Aspiration of air

45

40
Q

NEEDLE CRICOTHYROIDOTOMY

Indication????

Complications
______________ of cannula
______ventilation
____________

A

Failure to provide an airway by any other means

Malposition; Hypo; barotrauma

41
Q

SELF-INFLATING BAG (AMBU BAG)

___________ Bag, ___________ Valve, ___________ (BVM)

Indicated in patients not breathing or breathing inadequately – pt has to be ventilated

Bag size – infants, children, adults
Can be used with ————- and __________

A

Self inflating Bag, unidirectional Valve, Mask (BVM)

facemask & advanced airways

42
Q

Ambu bag

Delivers room air ____% oxygen if not connected to any oxygen source

Disadvantage-______________ with supraglotic devices.

A

21

gastric inflation

43
Q

AMBU BAG

1 - flexible mask to seal over the patients face
2 –_____-way valve & _____ (prevents __________ and ____________ )
3 - bag which is squeezed to expel air to the patient
4-oxygen port for administering supply O2

Self inflates with __________ or from ______ source when released

A

one; filter

rebreathing and bag contamination

room air; oxygen

44
Q

Self-inflating bag with reservoir Delivers up to _______% oxygen

A

100

Junior Anaesthesia (16 decks)

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