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AIRWAYS EXAM 1 > DIFFICULT AIRWAY > Flashcards

DIFFICULT AIRWAY Flashcards

1
Q

what are the infection variables of flexible fiberoptic bronchoscopy?

A
  1. personnel education and practice
  2. poor handling and disinfection practices
  3. preceeding patients’ contamination
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2
Q

in what kind of cases will you most often use FFOB?

A

emergent cases

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3
Q

what will you be expected to appropriately provide during rigid bronchoscopy?

A

TIVA and HPOV

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4
Q

what will you be expected to appropriately provide during FFOB?

A

inhalational anesthetics and manual or mechanical ventilation

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5
Q

what is the difference in field of view of a 2.7mm vs. 2.8mm diameter FFOB?

A

90º (2.7mm) vs. 120º (2.8mm)

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6
Q

what are the differences in channel diameter in 2.7mm, 2.8mm, 3.0mm, and 3.3mm diameter FFOBs?

A
  1. 7mm – 1.2mm channel
  2. 8mm – 2.0mm channel
  3. 0mm – 2.6mm channel
  4. 3mm – 2.8mm channel
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7
Q

what is the most preferential ETT size to use with FFOB?

A

size 8.0 ETT

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8
Q

what should you always do before setting up a FFOB?

A

put on gloves

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9
Q

what is the best method for clean-up for FFOBs?

A

saline suctioning

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10
Q

what are the three FFOB directional movements?

A

longitudinal, rotational, angulation

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11
Q

definition: movement along the long axis – allows you to enter and leave the airway

A

longitudinal movement

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12
Q

definition: movement around the long axis – allows you to move through aproximately 180º either clockwise or counterclockwise

A

rotational movement

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13
Q

definition: movement using the angulation control – allows flexion and extension of the tip from 90º to 180º in opposite directions

A

angulation movement

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14
Q

what is mandatory for visualization during flexible fiberoptic procedures?

A

creating an airspace

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15
Q

what are the dimensions of a standard aintree catheter?

A

4.7mm ID X 6.5mm OD X 56cm L

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16
Q

what is the best size ETT to use for an aintree catheter?

A

≥ 7.0mm ID ETT

17
Q

outline plans A, B, C, D,… n for the difficult airway

A

A. conventional DL and orotracheal intubation

B. endotracheal tube introducer

C. LMA – aintree catheter – FFOB

D. HPOV/ retrograde guidewire assisted intubation

…n. heliox during manual bag mask

18
Q

what is the purpose of the lumen of an ETT introducer?

19
Q

why do ETT introducer catheter have memory?

A

to create a 15º-30º bend in the distal 2cm

20
Q

what is the significance of the relative stiffness over a short distance of total catheter length?

A
  1. lift the body of the epiglottis, slide along the dorsal surface, advance through the glottis into the trachea
  2. tactile feedback when successful as catheter bumps over tracheal cartilages
21
Q

what are the two general precautions when using an ETT introducer catheter?

A
  1. must be able to see at least the tip of the epiglottis in order to slide the introducer into the larynx
  2. begin at a lesser angle (15º) at the tip/ be very gentle in the presence of infection, abscess, cyst, necrotic tissue, post irradiation
22
Q

name 2 complications of ETT introducer?

A
  1. tracheal abrasion
  2. tracheal, pharyngeal, laryngeal puncture (hemorhhage, hematoma, infection, abscess, mediastinitis)
  3. failure to obtain glottic entry
  4. failure to pass ETT
23
Q

how does ETT ID relate to length from 2.5mm to 6.0mm ID?

A

length increases by 4cm for every increase of 0.5mm ID

  1. 5mm ID – 38cm length
  2. 0mm ID – 42cm length
  3. 0mm ID – 50cm length
  4. 0mm ID – 58cm length
  5. 0mm ID – 66cm length
24
Q

how does ETT ID relate to length from 6.0mm - 7.5mm ID?

A

length increases 4cm from 6.0mm - 7.0mm ID, and 7.0mm - 7.5mm ID

  1. 0mm ID – 66cm
  2. 0mm ID – 70cm
  3. 5mm ID – 74cm
25
Q

what is the minimum length of the guidewire for retrograde wire assisted intubation?

A

60cm length minimum

26
Q

what is the necessary equipment for RGW-assisted intubation?

A

j-tipped guidewire (j-wire) – 0.035”

2 hemostats

small diameter ETT or ETT introducer

27
Q

what is the primary purpose of HPOV technique?

A

oxygenation not ventilation

28
Q

what is the life-threating problem related to loss of upper airway patency?

A

hypoxia not hypercapnia

29
Q

RGW-assisted intubation is indicated in what kind of upper airway obstructive problem?

A

ball-valve obstruction

30
Q

RGW-assisted intubation is contraindicated ​in what kind of upper airway obstructive problem?

A

complete obstruction

31
Q

when should HPOV equipment be assembled?

A

before cricothyorid puncture

32
Q

what equipment must be assembled before HPOV?

A

high-pressure, small diameter O2 supply tubing

3-way stopcock turned so that all three ports are open

AIRWAYS EXAM 1 (6 decks)

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