Chapter 6 : Surgical management of the difficult adult airway

Question 1

3 scenarios in a difficult airway

Answer 1

1. difficult tracheal tinubation, 2. difficult laryngoscopy, 3. difficult mask ventilation

Question 2

Elements of an infinitely difficult intubation

Answer 2

No intubation even with direct vision, full paralysis, optimal position, cricoid pressure, forceful elevation, multiple attempts

Question 3

Indicates for fiberoptic intubation

Answer 3

1. diffcult intubation, 2. compromised airway, 3. conscious intubaton, 4. high risk for dental damage

Question 4

Average size of the cricothyroid membrane in adults

Answer 4

1 x 2-3 cm

Question 5

Location of the cricothyrod arteries

Answer 5

superior aspect of the cricothyroid membrane

Question 6

Indications for cricothyrotomy

Answer 6

failure to intubate in the immediate need to establish an airway, inability to mask ventilate

Question 7

Relative contraindications for cricothyrotomy

Answer 7

Age < 10, severe neck trauma with indistinct landmarks, expanding hematoms, subglottic disease

Question 8

Most important step in cricothyrotomy

Answer 8

Stabilizing the the airway with the nondominant hand

Question 9

Complications of cricothyrotomy

Answer 9

Bleeding, trauma, laryngeal injury, vocal fold injury, pneumomediastimum/thorax, false passage, esophageal laceration

Question 10

First documented description of tracheostomy

Answer 10

Vesalius 1600s