Compromised Airway

Question 1

What is a emergency compromised airway? (3 things)

Answer 1

Upper airway obst where:

1. Can’t ventilate
2. Can’t intubate
3. Life threatening

Question 2

Where is the upper airway?

Answer 2

Above level of larynx

Question 3

What things mean you can’t intubate? (4 things)

Answer 3

1. Irretrievable foreign body
2. Facial oedema (burns)
3. Maxillofacial trauma
4. Inf (epiglottitis)

Question 4

What is the procedure for emergency airway management?

Answer 4

Cricothyroidotomy

= placing a tube through whole in neck for oxygen + ventilation

Question 5

How do you do a Cricothyroidotomy? (4 steps)

Answer 5

1. Lie patient supine (flat) with neck extended
2. Find Adams apple (upper border of thyroid cartilage)
3. Just below Adams apple, find cricothyroid membrane (depression between thyroid + cricoid cartilages)
4. Use special kit / needle / blade / pen to pierce it

Question 6

What are the complications of Cricothyroidotomy? (7 things)

Answer 6

1. Local haemorrhage +/- aspiration
2. Posterior perforation of trachea +/e oesophagus
3. Subglottic stenosis
4. Laryngeal stenosis
5. Tube blockage
6. Subcutaneous tunnelling
7. Vocal chord paralysis / hoarseness