Chapter 2: Airway Management

Question 1

Complete airway obstruction is likely when chest movement is _____ but breath sounds are ____

Answer 1

Visible, absent

p(14)

Question 2

How to position head to open airway (3)

Answer 2

slight neck extension (unless c spine injury)
elevation if mandible through jaw thrust
open mouth
(p15)

Question 3

Two contraindications for nasopharyngeal airway

Answer 3

suspected basilar skull fracture or coagulopathy

p 15

Question 4

Factors that make bag mask ventilation difficult (5)

Answer 4

beard
missing teeth
OSA
BMI over 26
age older than 55
(p 23)

Question 5

Containdications for Esophageal-Tracheal Double Lumen airway

Answer 5

centeal airway obstruction
intact laryngeal or pharyngeal reflexes
known esophageal pathology
ingestion of caustic substances
(p23)

Question 6

Indications for tracheal intubation (8)

Answer 6

airway protection
relief of obstruction
provision of mechanical ventilation
respiratory failure
shock
Hyperventilation for increased inter cranial hypertension
to reduce work of breathing
facilitation of suction/pulmonary toilet
(p24)

Question 7

Pharmacologic goals before intubation are

Answer 7

Analgesia, Anesthesia, and sedation without altering cardiopulmonary stability (p 26)

Question 8

Excessive use of benzocaine topical sprays can cause clinically significant _____

Answer 8

Methemoglobinemia (p26)

Question 9

____ acting, ____ lived, and ____ agents are used to prepare patient for intubation

Answer 9

Rapid, short, reversible (p27)

Question 10

succinylcholine dosing for neuromuscular blockade

Answer 10

1-1.5 mg/kg (p27)

Question 11

succinylcholine has a ____ onset and ____ duration

Answer 11

rapid, short (p27)

Question 12

succinylcholine is contraindicated when what type of injury is present

Answer 12

ocular, relative contraindication for head injury and hyper k (p28)

Question 13

Vecuronium dosing for neuromuscular blockade

Answer 13

.1-.3 mg/kg (p27)

Question 14

Why is succinylcholine preffered over Vecuronium , rocuronium, and Cisatracurium

Answer 14

it has a shorter duration of paralysis (p27)

Question 15

how to avoid increasing inter cranial pressure when intubating

Answer 15

1-1.5 mg/kg IV lidocaine (p27)

Question 16

Fentanyl Dosing, Benefits, and cautions

Answer 16

Dosing : 0.5-2 ug/kg iv every several minutes
Benefits: rapid onset, short acting, reversible w naloxone
Cautions: chest wall rigidity, respiratory depression, patient still aware of procedure (p28)

Question 17

Midazolam Dosing, Benefits, and cautions

Answer 17

Dosing : 0.1-0.3 mg/mg bolus titrated to sedative effect every several m minutes
Benefits: provides amnesia, rapid onset, short acting, reversible with flumazenil
Cautions: additive respiratory depression does not provide analgesia (p28)

Question 18

Etomidate Dosing, Benefits, and cautions

Answer 18

Dosing : 0.1-0.3 mg/kg single iv bolus
Benefits:provides hypnosis, maybe best for head injury, no adverse cardio effects
Cautions: myoclonus- tx fentanyl , no reversal, transient adrenal suppression (p28)

Question 19

Lidocaine Dosing, Benefits, and cautions

Answer 19

Dosing : 1-1.5 mg/kg iv bolus 2-3 minutes before laryngoscopy
Benefits: Blunts hemodynamic and tracheal response to intubation, may reduce elevation of intercranial pressure
Cautions: neurotoxicity (seizures) when over 4 mg/kg
(p28)

Question 20

Ketamine Dosing, Benefits, and cautions

Answer 20

Dosing : 1-4 mg/kg IV bolus
Benefits:rapid onset, no cardio effects, short acting
Cautions: increased icp, hallucinations,
(p28)

Question 21

Propofol Dosing, Benefits, and cautions

Answer 21

Dosing : 1-2 mg/kg iv bolus
Benefits: rapid onset, short acting, provides amnesia
Cautions:sever hypotension if volume down, no analgesia, respiratory depression
(p28)