Airway Management

Question 1

Sellick maneuver

Answer 1

Pressure on cricoid at front of neck will close off oesophagus.

Question 2

Airway landmarks:

Answer 2

15cm = vocal cords
20cm = sternal notch
25cm = carina

Question 3

Patent airway = open airway

Answer 3

1. Tongue and epiglottis lifted forward: modified jaw-thrust / jaw-lift maneuver
2. Observation: adequate tidal vol / monitor lung compliance / capnography / pulse oximetry
3. Suction
4. Adjuncts: NPA / OPA / BIAD / endotracheal airways

Question 4

External laryngeal manipulation:

Answer 4

Pressing thyroid cartilage backward against oesophagus and then upward and slightly to pts right.

Question 5

Rapid sequence intubation (RSI)

Answer 5

Technique to improve likelihood of intubating a difficult patient by administering a sedative and paralytic agent

Question 6

Predict difficult laryngoscopy and intubation:

Answer 6

Mallampati: I - entire tonsil / tonsillar bed visible
II - upper ½ of tonsil / tonsillar bed visible
III - soft and hard palate clearly visible
IV - only hard palate visible
Measurement 3-3-1: fit 3 fingers under chin between hyoid bone and mentum
3 fingers should fit between upper and lower incisors
Lower jaw should be able to protrude 1cm beyond upper teeth
Atlanto-occipital extension
Pathology

Question 7

Supplemental oxygen

Answer 7

Simple face mask @ 10 - 12L/min = 40% - 50% O2
Nonrebreathing with reservoir bag @ 10 - 12L/min = 60 - 90%
Nasal cannulae = 25 - 30%

Question 8

Tidal volume

Answer 8

Adults normally 400 - 600 cc air/ breath

Question 9

Minute volume

Answer 9

= tidal volume x RR

Normally 5 - 12L/min

Question 10

Normal ventilation

Answer 10

Produce O2 level of 100mmHg and CO2 of 35 - 45mmHg

Question 11

Predict difficult mask ventilation

Answer 11

Beards
Obesity
Older pts
Toothlessness
Snores/stridor

Question 12

Response to difficult bag-mask ventilation

Answer 12

1. Reposition
2. OPA / NPA
3. 2-person bag
4. Consider obstruction
5. BAID
6. Laryngoscopy and intubation

Question 13

Essential airway equipment:

Answer 13

1. O2 cylinder D
2. Portable suction units
3. O2 cannulae and masks
4. NPA and OPA
5. ET kit
6. BAID
7. Bag-mask with reservoir bag
8. Pocket mask
9. Pulse Oximeter
10. CO2 monitor
11. Translaryngeal O2 cannula and manual ventilator