chapter 7

Question 1

on which level is airway compromised the most ?

Answer 1

pharynx - at soft palate and epiglottis

Question 2

what causes laryngeal obstruction ?

Answer 2

laryngeal edema = from burns inflammation , anaphylaxis

laryngeal spasm = foreign body

Question 3

what will cause stridor ?

Answer 3

obstruction at laryngeal level

Question 4

what will cause wheeze ?

Answer 4

obstruction of lower airways

Question 5

complete airway obstruction clinical manifestation ?

Answer 5

see-saw breathing
paradoxical breathing

Question 6

obstruction of tracheostomy management ?

Answer 6

remove foreign material from soma or tracheal tube
remove tracheal liner if there is one

try to pass suction catheter - perform tracheal suction and ventilate

if suction catheter will not pass remove the tracheostomy tube - seal the stoma and use bag valve mask

Question 7

sequence of adult choking ?

Answer 7

signs of mild airway obstruction : encourage to continue coughing

severe :

support chest lean patient forward
5 sharp blows between scapula and heel of patient

and 5 abdominal thrust

if unconscious resus team

cpr may dislodge foreign body

laryngoscopy -removeforeign body with MAGILL’S FORCEPS

Question 8

complication of oropharyngeal airway ?

Answer 8

vomiting or laryngospasm

Question 9

what is used on patients partially conscious

Answer 9

nasopharyngeal airway

Question 10

what type of airway is used in those with clenched jaw , truisms or maxillofacial injuries ?

Answer 10

nasopharyngeal airways

Question 11

if there is basal skull fracture what type of airway management is preferred ?

Answer 11

oropharyngeal

Question 12

side effects nasopharyngeal airways

Answer 12

cannot be measured through anatomical position of the face and mouth
6-7mm suitable in adults
insertion can cause damage to the mucosal lining of nasal airway - bleeding
if tube too long stimulations laryngeal or glossopharyngeal reflex - vomiting or laryngospasm

Question 13

how is a rescuers expired oxygen ?

Answer 13

16-17 percent

Question 14

what are the infections that can be transmitted upon CPR ?

Answer 14

TB and severe acute resp distress syndrome
COVID -19 - CONTRA FOR MOUTH TO MOUTH resus

Question 15

disadvantages of bag mask ?

Answer 15

difficult to achieve gas tight seal
and maintain patent airway with one hand and squeeze the bag with the other
airway not patent - can go to the stomach - GASTRIC DISTENTION
2 PEOPLE ALWAYS PREFERRED- needs to be skilled = or in effective tidal volumes and cause gastric inflation with risk of regurgitation and pulmonary aspiration

Question 16

how should two people work the bag mask

Answer 16

one person holds the face mask in place using jaw thrust with both hands and an assistant squeezes the bag
=OROPHARYNGEAL ALWAYS CONSIDERED WHEN USIN A MAG MASK VENTILATION

Question 17

benefits of supraglotti airway ?

Answer 17

i-gel = faster insertion than most airway management
not much skills required
gastric inflation minimised
regurgitation minimised and aspiration very rare

ALWAYS PREFERED O BAG MASK VENTILATION

can be inserted through chest compressions

Question 18

how to put I-gel supraglottic airway ?

Answer 18

APPROPRIATE SIZE I-GEL - size 4 in most adults
lubricate the back , sides and front of i gel cuff
ensure patient in sniffing the morning air position - head extended , neck flexed and gently press the chin down
glide device downwards and backwards along the HARD PALATE
if resistance = jaw thrust and slightly rotate device

CORRECT POSITION - TIP AT UPPER ESOPHAGEAL opening
cuff located at larynx
incisors resting at bite block

Question 19

disadvantages of i gel - supraglottic airway

Answer 19

in presence of high air resistance and poor pulmonary compliance = pulmonary edema , COPD , bronchospasm
= risk of leak around cuff = causing hypoventilation =

Question 20

what is done of tracheal intubation has failed and BAG VALVE MASK ventilation is impossible ?

Answer 20

LMA - laryngeal mask airway
SUPRA GLOTTIC AIRWAYS

Question 21

benefits of tracheal intubation ?

Answer 21

trial and research has shown no significant advantage of one airway management over the other
patent airway protected from aspiration of gastric contents, or blood from oropharynx
provide adequate tidal volume through cpr
free rescuer hands
suck out air way secretions

Question 22

DISADVANTAGE OF TRACHEAL TUBE INTUBATION

Answer 22

CPR INTERRUPTIONS - brief paise in cpr - only when passing vocal cords
so defer this until ROSC

needs real skilled people

Question 23

in which cases can laryngoscopy and attempted intubation be life threatening and impossible and causes deterioration

Answer 23

acute epiglottitid
pharyngeal and laryngeal disse
head injury
cervical spine injury

= needs aesthetic drugs , video laryngoscopy , flexible fibreoptic laryngoscopy

Question 24

with airway management how to know