Airway management Flashcards
Regarding chest injuries, which one of the following statements is correct?
Liver and splenic injuries re recognised complications of lower rib fractures
When dealing with a player with an obstructed airway following a traumatic tackle on the pitch, which one of the following is the correct sequence of actions – assuming it is safe to approach?
Immobilisation of neck, assess response, look in airway, suction of airway if required, jaw thrust and oxygen
At a football event, a young player has suffered a potential c-spine injury. You and your colleagues have managed the player using manual in-line c-spine stabilisation (MILS). You’ve applied a well-fitting cervical stiff neck collar, appropriately placed her onto a spinal board and she is fully secured with a spider harness in situ. As you are about to complete the extrication using head blocks, she begins to wretch, and it is obvious she is about to vomit.
What is your next immediate action? Select the most appropriate correct answer.
Use a controlled log roll with c-spine control to tilt the board
In an emergency situation on the field of play, it is apparent that your player requires suction to relieve the presence of copious amounts of secretions in their mouth.
What are of the following statements are correct regarding the use of suction?
A player who has had suction may require hyper oxygenating
The suction catheter is inserted into the player’s mouth as far as you can see
As the medic, you should attempt to limit the time of suctioning to 15-20 seconds
Any suction catheter is single-use
A gauze pad may be used to wipe out larger pieces of debris
Regarding airway management during an emergency situation on the field of play, which one of the following statements is correct?
An airway can be at risk to any unconscious player
Having decided clinical indicators point towards effective management requiring needle decompression, which one of the following represents the correct landmarks for needle thoracocentesis?
Insert a large bore cannula (14g) at 90 degrees into the thoracic cavity at the level of the second intercostal space, just above the third rib in order to avoid the neurovascular bundle immediately below the lower border of the second rib, in the midclavicular line. If this site is unsuccessful, unavailable or further intervention is required, use the fifth intercostal space at the upper border of the sixth rib in the mid-axillary line.
When discussing airway and breathing management in the presence of a suspected cervical spine injury, which one of the following statements is correct?
Maintaining a patient airway takes priority over a suspected c-spine injury
Clinical signs and symptoms of a tension pneumothorax
(In the clinical setting, a player presents with the signs/symptoms of a tension pneumothorax (post-contact trauma with the goalpost). Which one of the following signs/symptoms would you not expect to find as a clinical indication for performing a needle thoracocentesis?)
Increasing respiratory distress
Absent breath sounds on the affected side
Distended neck veins
Hyper-resonance to percussion note on the affected side
Tracheal deviation away from the affected side
Clinical presentation of a haemothorax:
(A player has suffered a severe chest injury on the field of play after a foul play incident challenging for a high ball. After a full A-E assessment, you are happy there are no other associated injuries. The player is fully immobilised on oxygen and extricated to the medical room whilst awaiting ambulance arrival. In the medical room, you are able to perform a more detailed chest assessment.
Which one of the following clinical presentations would not be a presentation of a haemothorax in this situation?)
Decreased expansion on the affected side
Increased heart rate
Increased respiratory rate
Decreased breath sounds on the affected side
Hypo-resonance note on percussion on the affected side
Using the Resuscitation Council (UK) guidance on adult choking, can you clarify what to do in severe and mild airway obstruction:
Severe:
1. Unconcious player. Start CPR
2. Conscious player. 5 back blows, 5 abdominal thrusts
Mild:
1. Encourage coughing. Continue to check for deterioration to ineffective cough until the obstruction is cleared.
What is the purpose of bag valve mask ventilation and when should consideration be given to its use in football?
Purpose is to provide positive ventilation. Consideration to use should be given when a player is not breathing normally or not breathing adequately by a two-person technique
You are called onto the pitch for an unconscious football player. The play is in supine lying following an unwitnessed collision during a cup match. On assessment with MILS in situ, they present with a noisy airway (‘snoring’) and clenching of their jaw. They localise with a pain response to the application of a jaw-thrust. At present, they are unable to maintain their own airway and return to snoring as the jaw-thrust is released.
Which one of the following would be the airway adjunct of choice in this situation?
Nasopharyngeal airway
You are the medical cover at a football match when one of the players suddenly collapses. After confirmation of cardiac arrest, you commence resuscitation together with your ATMMiF trained colleagues. You use a pocket mask, 30:2 and apply the AED within 90 seconds. After delivery of the first shock, you notice a return of spontaneous circulation with a heart rate of 50bpm and a respiratory rate of 6rpm. You decide to continue with assisted ventilation.
Which one of the following best describes the most effective method in which you should assist ventilations in this player?
Continue using the pocket mask whilst your colleague attaches oxygen to a bag and mask. Apply a two-handed technique lifting the jaw up into the mask and your ATMMiF colleague squeezes the bag aiming at a tidal volume of approximately 500ml, synchronising with the spontaneous breaths to deliver a total respiratory rate of 10-12rpm
What are the facts on nasopharyngeal airways
(When inserting a nasopharyngeal airway into a player who requires airway management, which one of the following statements is not correct?)
Do not use with a nasal fracture
A nasopharyngeal airway is better tolerated by players who have a fluctuating level of consciousness
A nasopharyngeal airway can be used in a player who is actively fitting, following head trauma and is easier to administer in comparison to an oral airway in this scenario
A nasopharyngeal airway is the airway of choice in the presence of head trauma, an altered level of consciousness and trismus
When sizing a nasopharyngeal airway, the correct size should be slightly smaller than the player’s nostril and inserted with the bevelled edge towards the septum
Referencing the use of a bag valve mask (BVM) in the emergency setting, which one of the following statements is incorrect?
check
A two-person technique provides the best opportunity for an effective seal
Lung ventilation should be aimed at normal tidal volume of approximately 500ml
Correct use of a BVM attached to high flow oxygen delivers effective ventilations, with close to 100% inspired oxygen concentration
A BVM can only be used to provide ventilations to a player who has altered breathing
A ‘C’ grip can be utilised to maintain chin lift into the mask allowing for an effective seal
