Airway Management

Question 1

Why is it important to maintain a patent airway?

Answer 1

Loss of consciousness often leads to airway compromise or obstruction, which affects ventilation and oxygenation.

Question 2

What are the three main methods of airway maintenance?

Answer 2

Supraglottic airway devices, infraglottic airway devices, and surgical airways.

Question 3

What are examples of supraglottic (upper) airway devices?

Answer 3

Oro/naso-pharyngeal airway, laryngeal mask airway, i-gel.

Question 4

What are examples of infraglottic (lower) airway devices?

Answer 4

Endotracheal tube, combitube, laryngeal tube.

Question 5

Name two surgical airways.

Answer 5

Cricothyroidotomy, tracheostomy.

Question 6

Describe the shape and use of an oropharyngeal airway (OPA).

Answer 6

A J-shaped device, e.g., Guedel’s airway, inserted through the mouth to maintain airway patency.

Question 7

What sizes are available for oropharyngeal airways?

Answer 7

Sizes range from neonate to large adult (Paediatric sizes 000-2; Adult sizes 3-5).

Question 8

How do you size an oropharyngeal airway?

Answer 8

Measure from the angle of the mouth to the earlobe or centre of the incisor to the angle of the jaw.

Question 9

What happens if an oropharyngeal airway is too large?

Answer 9

It may obstruct the larynx or cause trauma.

Question 10

What are the risks of using an oropharyngeal airway that is too small?

Answer 10

It may push the base of the tongue posteriorly, leading to airway obstruction.

Question 11

How do you insert an oropharyngeal airway in adults?

Answer 11

Open the mouth, insert the airway in an upside-down position, rotate it 180°, and advance until it lies in the pharynx.

Question 12

What is the correct insertion technique for an oropharyngeal airway?

Answer 12

The airway is inserted upside down, then rotated 180° to prevent pushing the tongue backwards.

Question 13

What is a nasopharyngeal airway?

Answer 13

An airway device inserted through the nose to bypass the mouth and oropharynx.

Question 14

When is a nasopharyngeal airway contraindicated?

Answer 14

Contraindicated in cases of fractured skull base or nasal trauma.

Question 15

How do you size a nasopharyngeal airway?

Answer 15

Measure from the tip of the nose to the earlobe, and diameter should be equal to or smaller than the patient’s little finger.

Question 16

Describe the insertion steps for a nasopharyngeal airway.

Answer 16

Select size, lubricate the device, insert bevel end vertically with slight twisting, and ensure it rests against the nasal opening.

Question 17

What is a laryngeal mask airway (LMA)?

Answer 17

An alternative to facemasks or tubes, placed above the larynx.

Question 18

What are the indications for using a laryngeal mask airway?

Answer 18

Used during general anaesthesia, short surgical procedures, CPR, or when quick airway patency is needed.

Question 19

What are the contraindications for using a laryngeal mask airway?

Answer 19

Limited mouth opening, facial trauma, risk of aspiration, etc.

Question 20

List some advantages of using a laryngeal mask airway.

Answer 20

Quick placement, minimal expertise needed, stable hemodynamics, and improved oxygen saturation.

Question 21

List some disadvantages of using a laryngeal mask airway.

Answer 21

Inadequate positive pressure ventilation, risk of aspiration, sore throat, and nerve damage.

Question 22

What is an i-gel airway device?

Answer 22

A supraglottic airway device made from gel-like material, with a bite-block and narrow drain tube.

Question 23

What is a ProSeal LMA?

Answer 23

A reusable LMA with a drain tube, posterior cuff, reinforced airway tube, and high seal pressure.

Question 24

What is a LMA-Supreme?

Answer 24

A second-generation LMA with an inflatable plastic cuff, oesophageal drain tube, and semi-rigid tube.

Question 25

What is a combitube and its purpose?

Answer 25

A double-lumen tube used for airway management, allowing ventilation whether it enters the trachea or oesophagus.

Question 26

What is a laryngeal tube?

Answer 26

A single lumen tube with oesophageal and pharyngeal cuffs for airway management.

Question 27

Describe the endotracheal intubation process.

Answer 27

The process involves inserting a tube through the nose or mouth into the trachea to secure the airway.

Question 28

What preparation is required for endotracheal intubation?

Answer 28

Preparation includes oxygen supply, suction apparatus, laryngoscope, endotracheal tubes, and an assistant.

Question 29

What sizes of endotracheal tubes (ETT) are available for paediatric patients?

Answer 29

ETT size = age (yrs)/4 + 4.5 mm, cuffed or non-cuffed.

Question 30

How is the correct placement of an ETT confirmed?

Answer 30

Confirm with bilateral chest expansion, equal breath sounds, and waveform capnography.

Question 31

What are the complications of endotracheal intubation?

Answer 31

Unrecognised oesophageal intubation, trauma, infection, or airway injury.

Question 32

What is a needle cricothyrotomy and when is it indicated?

Answer 32

An emergency procedure to establish an airway when all other methods fail.

Question 33

What are the steps for performing a needle cricothyrotomy?

Answer 33

Identify cricothyroid membrane, puncture with a needle, confirm placement, and connect to oxygen.

Question 34

What is a self-inflating bag (AMBU bag)?

Answer 34

A device used to provide ventilation to patients not breathing or inadequately breathing.

Question 35

What are the disadvantages of using an AMBU bag?

Answer 35

Potential for gastric inflation, which may lead to regurgitation or aspiration.

Question 36

What is the purpose of a one-way valve and filter in an AMBU bag?

Answer 36

It prevents rebreathing and contamination of the bag.

Question 37

What is the ventilation rate for a bag-mask during cardiac arrest?

Answer 37

2 ventilations after every 30 compressions.

Question 38

What is the ventilation rate for an advanced airway during respiratory arrest?

Answer 38

1 ventilation every 6 to 8 seconds.

Question 39

What is the E-C clamp technique used for?

Answer 39

To maintain a patent airway in an unconscious child without compressing soft tissues.

Question 40

What are some complications associated with needle cricothyroidotomy?

Answer 40

Malposition of the cannula, hypoventilation, barotrauma.