CHAPTER 6: Surgical Management of the Difficult Adult Airway

Question 1

Remain a LEADING cause of serious INTRAOPERATIVE complications

Answer 1

Difficulties with INTUBATION and EMERGENT AIRWAY

Question 2

Percentage of deaths attributable to anesthesia involve failure to manage the difficult airway

Answer 2

25%

Question 3

The risk of anoxic injury or death increase in____

Answer 3

DIRECT PROPORTION to the degree of difficulty in maintaining a patent airway

Question 4

The medical provider experiences significant difficulty with either VENTILATION or INTUBATION

Answer 4

Difficult airway

Question 5

Multiple attempts are needed to establish an airway

Answer 5

Difficult tracheal intubation

Question 6

Incidence of intubation failure in elective cases

Answer 6

0.1%

Question 7

Inability to visualize any portion of the vocal folds after multiple attempts at conventional laryngoscopy

Answer 7

Difficult laryngoscopy

Question 8

A condition in which it is not possible to provide adequate facemask ventilation

Answer 8

Difficult mask ventilation (DMV)

Question 9

Patient factors that have been found to be associated with difficulty ventilating and intubating

Answer 9

1. Mallampati score of III/IV
2. Neck radiation or mass
3. Male sex
4. Limited thyromental distance
5. Body mass index (BMI) greater than 30
6. Age greater than 46 years
7. Presence of a beard
8. Thick neck
9. Sleep apnea
10. Limitation of neck extension or limited jaw protrusion

Question 10

Three components of pharmacologic preparation for awake FOI

Answer 10

1. Premedication
2. Limited secretion
3. Application of topical/local anesthesia

Question 11

Establishment of a surgical opening into the airway through the

Answer 11

Cricothyroid membrane

Question 12

Primary indication for a cricothyrotomy

Answer 12

Inability to intubate in the presence of an immediate need for definitive airway management and an inability to ventilate the patient with a mask

Question 13

Most common errors in the management of the difficult airway

Answer 13

Repeated unsuccessful attempts at intubation

Question 14

Relative contraindications for cricothyrotomy

Answer 14

1. Age younger than 10 years
2. Severe neck trauma with inability to palpate the landmarks
3. Expanding neck hematoma
4. Laryngeal disease with subglottic extension