Airway Management - Workbook Questions Flashcards
What size suction catheter should the specialist choose for a child with a size 4.0 trach tube?
4
6
8
10
tube size divided by 2, then multiply by 3.
Two minutes after removing an endotracheal tube from a 10 year old boy, the specialist notices that the patient has developed moderate inspiratory stridor. The most appropriate action would be to
administer oxygen
administer racemic epinephrine
manually ventilate using bag and mask
re-intubate
administer oxygen.
Oxygen is ALWAYS the first drug.
The specialist performs auscultation on a 6 year old child who has just been intubated. BBS are heard but are louder on the right with decreased chest movement on the left. The most appropriate action at this time would be to
insert a chest tube into the right thorax
remove the tube and prepare to re-intubate
withdraw the tube a few centimeters and reassess BBS
request a right lateral x-ray
withdraw the tube a few centimeters and reassess BBS.
Which of the following are indications that a child’s tracheostomy tube should be replaced?
- infection at the tracheostomy site
- inspissated secretions are aspirated
- a suction catheter cannot be passed
- cuff pressure at minimal leak is 35cmH2O
1 and 2
3 and 4
2, 3, and 4
1, 2, 3, and 4
3 and 4
A tube should only be replaced if:
a catheter cannot be passed through
>20 of cuff pressure is needed to seal the airway
>20 of PPV on an uncuffed tube doesn’t leak
cuff is blown
The specialist has difficulty suctioning thick secretions from a 7 year old girl with CF. The specialist should
increase the vacuum pressure to 120
aerosolize pulmozyme before suctioning
instill acetylcysteine before suctioning
change to a larger catheter
Aerosolize Pulmozyme before suctioning the patient.
A 10 year old boy with a cuffed tracheostomy tube is receiving volume ventilation. At the beginning shift, a minimal leak was established at a peak inspiratory pressure of 34. Four hours later, the specialist notes that the peak inspiratory pressure is now 19. The most appropriate action at this time would be to
increase the set minute volume
repeat the minimal leak procedure
suction the patient
change to an uncuffed tracheostomy tube
Repeat the minimal leak procedure.
A physician performing endotracheal intubation on a 7 year old child is unable to visualize the laryngeal structures. the specialist should
suggest the physician place the tip of the laryngoscope below the vallecula
administer cricoid pressure
suction the upper airway
administer a topical anesthetic
Administer cricoid pressure
Which of the following suggestions would reduce the risk of ventilator associated pneumonia for a child with ARDS?
use of a closed suction catheter
prone positioning
recruitment maneuvers
use of an SVN
Use of a closed suction catheter
Which of the following conditions would increase the difficulty of performing endotracheal intubation?
Tetralogy of Fallot
Congenital Diaphragmatic Hernia
DiGeorge’s Syndrome
Treacher Collins Syndrome
Treacher Collins Syndrome
Treacher Collins is a craniofacial syndrome that is associated with increased difficulty of intubation
Which of the following should the specialist recommend in order to facilitate nasotracheal suctioning in a 7 year old child?
LMA
OPA
NPA
Coude tip catheter
NPA.
An indication for NPA use is to facilitate NT suction.
Which of the following should the specialist recommend prior to endotracheal intubation of a 12 year old child?
Edrophonium
Flumazenil
Naloxone
Succinylcholine
Succinylcholine
Intubation meds will include a sedative, “lams and pams” and an NMBA, such as succinylcholine or vecuronium.
What size ETT should the specialist choose for intubating a 12 year old child?
- 0
- 5
- 0
- 5
7.0
ETT sizing rule:
Age + 16, then divide by 4
12 + 16 = 28
28 / 4 = 7
After attaching a tracheal speaking device to the tracheostomy tube of a 13 year old child, the specialist notes that the child is in moderate respiratory distress with supraclavicular retractions. SpO2 has changed from 93% to 81%. The specialist’s first action should be to
verify that the cuff is deflated
auscultate breath sounds over the trachea
administer racemic epinephrine
request a lateral neck x-ray
Verify that the cuff is deflated.
The cuff should always be deflated when a PMV is in use, or the pt will not be able to exhale.
The specialist has made two unsuccessful attempts at endotracheal intubation for a 9 year old child who survived a near drowning. After providing ventilation with a manual resuscitation bag and mask the specialist should
request the assistance of a physician
attempt endotracheal intubation
perform a cricothyrotomy
prepare for emergency tracheotomy
Attempt endotracheal intubation
You have 3 attempts at endotracheal intubation on the exam.
Which of the following would be an acceptable vacuum pressure for suctioning a full term neonate?
30
45
55
70
70
Vacuum pressure for a neonate = 60-80
Pediatrics = 80-100
