Airway Obstruction Flashcards
What is the larynx made up of ?
Cartilages and ligaments. It is the junction between the upper and lower respiratory tracts
True or False. In a patient with a patent airway, the vocal cords should vibrate freely
False. the vocal cords do not vibrate - they move gently together
When do the vocal cords abduct
When you breathe
When do the vocal cords adduct
When you speak
Give some main differences of a child’s airways
Obligate nasal breather Large tongue Narrow subglottis Large head Small nares Small, soft larynx Higher position Weak neck muscles; floppy head
Why is the airway at risk with epiglottitis and croup
Due to a change in pressure caused by obstructive airflow, the soft part of the larynx will collapse
Describe the relationship between the radius of an airway and the work of breathing
The smaller the radius, the larger the work of breathing
Name possible causes of an airway obstruction
Inflammatory / infective causes / allergy foreign bodies physical compression invasion of airway trauma/ Iatrogenic trauma Neurological causes Neoplastic causes Burn Congenital airway pathology
Name some signs and symptoms of an airway obstruction
SOB on exertion SOB at rest Stridor Coughing choking inability to complete a sentence sternal / subcostal recession tracheal tug dusky skin colour of skin dysphagia dysphonia pyrexia cyanosis
What is stridor
High pitched harsh noise due to turbulent airflow resulting from airway obstructions
What is starter
Low pitched sonorous sound arising from nasopharyngeal airway
What might have to happen to a child with obstructive sleep apnoea
Removal of the adenoids and tonsils
On a chest xray, what are the signs that there is an obstruction
A lung may go almost completely “black” as it fills up with CO. If the other lung was not affected then it would look normal
Possible trachea deviation - mediastinal shift
What causes recurrent respiratory papillomatosis
HPV of the larynx
Describe the appearance of recurrent respiratory papillomatosis
Cant see the vocal cords - they are covered in small spots
Can cause severe breathing problems especially in kids
Where does the subglottis lie
Between the cricoid and vocal cords
What is subglottic stenosis
A narrowing of the airway below the vocal cords (subglottis) and above the trachea. Subglottic stenosis will involve narrowing of the cricoid, the only complete cartilage ring in the airway.
What causes subglottic stenosis in adults
Idiopathic
Vasculitis
What is the most common cause of subglottic stenosis in adults
Vasculitis
What is the most important thing to do for a patient with burns
Insert a tube FAST
What 3 things need to be part of your assessment
Appearance - do they look ill
Skin circulation - cyanosis and cap refill
Work of breathing - can you hear breathing? You shouldn’t - work goes up with obstruction
What could be the sequence of events in a child with an airway obstruction
Respiratory Distress
Respiratory Failure
Respiratory Arrest
Cardiac Arrest
What is heliox
A mixture of helium and oxygen that can make breathing easier
What is the basic management for airway obstruction
ABC resus oxygen heliox steroid adrenaline flexible fibre-optic endoscopy secure airway with ET tube / tracheostomy treat underlying pathology
