Airway Management

Question 1

does smoking make someone ASA II?

Does day one of quitting change it?

Answer 1

yes…

yes

Question 2

how many fingers do you need to not be at risk for jaw opening distance and thyromental distance?

Answer 2

3 fingers

Question 3

Mallampati Score Classification
class 1?
class 2?
class 3?
class 4?

Answer 3

1: can see all of uvula and tonsils pillars
2: can see part of uvula and soft palate with sauces
3: soft palate and base of uvula
4: hard palate only

Question 4

oropharyngeal airway management
sized from what to what?
can it be placed in conscious patient?

Answer 4

sized from commissure to mandible angle

cannot be placed in conscious

Question 5

nasopharyngeal airway management
sized from what to what?
can it be placed in conscious patient
avoid in patients with history of what 2 things?

Answer 5

MUST BE LUBRICATED
from naris to mandible angle
can be placed in conscious
avoid with history of epistaxis and cleft palate repair

Question 6

Supraglottic Airway
does cuff seal?
what feature reduces aspiration risk?
what feature prevents rotation?
can tube be crushed

Answer 6

no
gastric channel
oblong shaft
no (internal bite block)

Question 7

what is used to break laryngospasm?

Answer 7

bag valve mask

or jaw thrust technique

Question 8

T/F: bag valve mask doesn’t require e cylinder of oxygen

T/F: the bag valve can inflate a patient’s stomach if you are not careful

Answer 8

false

true

Question 9

What is the most important object in the room that is required for all sedation cases?

Answer 9

Yankauer suction (oral surgery suction)

Question 10

Apnea rescue algorithm
signs? 
if cause is obstruction?
if cause is pharmacologic?
Last step needed for rescue?

Answer 10

signs: no delay in stethoscope, capnography 3-4 sec. delay, oximetry 30-45 sec delay
obstruction: head tilt, remove debris
pharm: most likely be opioid or benzo so reverse those
MECHANICAL VENTILATION

Question 11

What is it called when vocal cords spasm preventing breathing?
what causes this?

Answer 11

laryngospasm

can be caused by irritation of cords from saliva/blood/debris

Question 12

Laryngospasm rescue algorithm
signs?
steps?
pharmacological help?
surgical help?

Answer 12

signs: crowing sound, rocking motion
need to stop irritating factor, provide jaw thrust (pain is respiratory stimulus), provide positive pressure with bag valve (hold pressure for 10-20 sec), then go to pharm
Pharm: 20-30 mg Propofol IV, succinylcholine
surgical: cricothyrotomy if all else fails

Question 13

what is it called when bronchiolar smooth muscle constricts?

Answer 13

bronchospasm

Question 14

what causes a bronchospasm?

Answer 14

irritation of small airways, smoking/pollution/infection/instrumentation/asthma/etc.

Question 15

bronchospasm rescue algorithm
signs?
steps?
pharm?
what do you need to rule out

Answer 15

signs: wheezing/shark fin capnography, increased expiratory time
administer albuterol and 10 mcg IV epinephrine
rule out anaphylaxis

Question 16

do healthy patients need difficult airway algorithm?

Answer 16

no

Question 17

what color light is absorbed by oxyhemoglobin?

what color is absorbed by deoxyhemoglobin?

Answer 17

1. red

2. infrared

Question 18

can oxygen bind to ferric or ferrous state hemoglobin? What are the states of hemoglobin called when they are in the ferric and ferrous state?

Answer 18

ferrous state can bind oxygen

ferrous: oxyhemoglobin
ferric: deoxyhemoglobin

Question 19

if you’re SpO2 monitor is stuck at 85%, what are you reading?

Answer 19

methemoglobin (bound to carbon monoxide)

Question 20

does carboxyhemoglobin absorb infrared or red light?

Answer 20

red light

Question 21

T/F: fingernail polish can not affect pulse oximetry

Answer 21

false

Question 22

T/F: when oxygen binds to hemoglobin the affinity for more oxygen incrases

Answer 22

true

Question 23

does a tense or relaxed form bind to oxygen better?

Answer 23

relaxed

Question 24

is the tensed form of hemoglobin found in muscles or the lungs?

Answer 24

muscles

Question 25

conditions that push hemoglobin/oxygen reaction to the tensed form?

Answer 25

increased temp.
increased 2,3 BPG
increased CO2
decreased pH

Question 26

conditions that push hemoglobin/oxygen reaction to the tensed form?

Answer 26

decreased temp
deceased 2/3 BPG
decreased CO2
increased pH

Question 27

oxygen dissociation curve
what type of hypoxia is 90-94%
what type is 85-89%?
<84%?
<65%?

Answer 27

mild
moderate
severe
cyanosis

Question 28

when hypoxia happens, does oximetry show it right away?

Answer 28

no, there is always a delay of at least 20-30 seconds up to 90 seconds

Question 29

please tell me you know hypertension….

Answer 29

if you don’t, get it together

Question 30

3 wire cable placement for ECG?

Answer 30

white cable: right arm (right is white)
black cable: left arm (smoke over fire)
red cable: lower limb

Question 31

T/F: use of capnogrphy is now required by law in all sedation cases

Answer 31

true

Question 32

what provides instantaneous recognition of hypoxia

Answer 32

precordial stethoscope