Chapter 19 Support of the airway and ventilation

Question 1

What are the complications of in inflated stomach?

Answer 1

Vomiting
Vagal stimuli
Diaphragmatic splinting

Question 2

What is more effective at getting a good view of the vocal cords in a young child, a macintosh blade or miller blade?

Answer 2

Equally effective. Use what you are used to

Question 3

What is better to use in a young child, a cuffed or uncuffed ETT?

Answer 3

Unless a neonate < 3kg, it doesn’t matter. Cuffed tube allows for better seal. As long as pressures are monitored they are safe.

Neonate < 3kg use uncuffed

Question 4

A patient is on a ventilator and the end tidal CO2 suddenly falls to zero.
What are 3 scenarios to explain this?

Answer 4

Disconnection in breathing system
Ventilator failure
Extubation

Question 5

What does the DOPA mnemonic stand for regarding assessment of ventilator problems?

Answer 5

D - Displaced (endobronchial or eosphageal)
O - Obstructed (blocked, kinked ETT)
P - Pneumothorax
E - Equipment problems (ventilator problems, leaks, disconnection, O2 supply failure or disconnection)

Question 6

You think there may be problem with the ventilator equipment for an intubated patient but it’s not readily obvious what it is. They are deteriorating. What should you do?

Answer 6

Hand ventilate while equipment is checked

Question 7

You think a patient has partially blocked tracheostomy tube, what is the first thing you should do?

Answer 7

Insert a suction catheter

Question 8

A partial has partially blocked tracheostomy tube and you have passed suction catheter but the issue is ongoing, what should you do?

Answer 8

Replace tube with a trachoestomy tube of the same size, if this doesn’t work try a size down.

Question 9

You have tried to re-insert a new tracheostomy tube as the old one was blocked but you can’t insert it. You tried a smaller size no success. What now?

Answer 9

Insert a lubricated suction catheter and threat the tube over it

Question 10

When giving O2 to child in respiratory distress with a tracheostomy tube, where do you put the O2 mask?

Answer 10

Both on their face and over the stoma

Question 11

A patient has a stoma but patent upper airway, you are giving bag-valve mask ventilation to the face. What do you do with the stoma?

Answer 11

Occlude it