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E1: Airway/respiratory Emergencies Flashcards

1
Q

What is the most common cause of airway obstruction?

A

The tongue

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2
Q

What are the low flow oxygen systems?

A

2-8 L

-Nasal cannula, simple or partial rebreathing, nonrebreathing, tracheostomy collar

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3
Q

What are the high flow oxygen systems?

A
  • up to 40L

- Aerosol masks, T pieces, venture masks

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4
Q

What is the use of manual resuscitation bags?

A
  • Used for resuscitation and manual ventilation, can deliver FiO2 >0.9 and tidal volumes up to 800mL
  • can deliver PEEP
  • Oxygen flow must be 10-15 L/min
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5
Q

What are the three different types of airways?

A

-Oral, nasal, laryngeal mask

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6
Q

What is the clinical presentation of a foreign body aspiration in a toddler?

A

-Persistent cough and possibly unilateral wheezing
-no URI symptoms
-decreased BS
-

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7
Q

What is the most common location for an aspirated foreign body?

A

Right lung, specifically the right bronchus

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8
Q

What are the two types of facial fractures that can lead to airway trauma?

A

LeForte fractures and Basilar skull fractures

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9
Q

Which kinds of LeForte Fractures are likely to have cribriform fractures?

A

LeForte II and III

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10
Q

What are the signs of a basilar skull fracture?

A

Battle signs (bruising of the mastoid), raccoon eyes, and CSF from the nose and/or ears

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11
Q

What is the DOC for anaphylaxis?

A

Epinephrine

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12
Q

What are the common causes of anaphylaxis?

A
  • Abx
  • ASA and NSAIDs
  • Shellfish, nuts, eggs, and milk
  • Bee stings
  • grasses
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13
Q

What is the clinical presentation of anaphylaxis?

A
  • Onset of seconds to hours
  • angioedema
  • tightening sensation of throat
  • laryngeal swelling and bronchial spasm
  • respiratory distress and apnea
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14
Q

What is the treatment of anaphylaxis?

A
  • airway management
  • oxygen
  • epinephrine
  • antihistamines
  • Beta 2 agonists
  • steroids
  • ET tube
  • surgical airway
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15
Q

What is the dosing of epinephrine?

A
  • IM is better than SQ

- 0.01mg/kg up to a maximum of 0.5mg

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16
Q

What are the causes of angioedema?

A
  • Hereditary: insuffient synthesis of C1 esterase inhibitor

- Acquired (ace inhibitors)

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17
Q

What is the treatment of angioedema?

A
  • airway management
  • supportive
  • plasma concentrate of C1 esterase inhibitor
  • epinephrine, antihistamines, steroids
  • Danazol
  • ecallantide (kallikrein inhibitor)
  • Icatibant (bradykinin receptor antagonist)
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18
Q

What drug is specifically used for hereditary angioedema?

A

Danazol

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19
Q

What is Ludwigs angina?

A

Bilateral, rapidly spreading submandibular cellulitis

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20
Q

What are the signs of Ludwigs angina?

A
  • Tongue elevated
  • Hard, firm induration of the floor of the mouth
  • perioral edema
  • pain
  • trismus
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21
Q

What is the management of Ludwigs angina?

A

Surgery

  • awake fiberoptic nasal intubation
  • sometimes awake tracheostomy
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22
Q

What is a retropharyngeal abscess?

A

A localized collection of pus in the retropharyngeal space

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23
Q

What are the causes of retropharyngeal abscess?

A
  • Mixed gram negative and anaerobic bacteria
  • tonsillitis
  • otitis media
  • pharyngeal trauma
  • Odynophagia
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24
Q

What are the signs and symptoms of retropharyngeal abscess?

A
  • Fever
  • odynophagia
  • drooling
  • neck swelling
  • torticollis
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25
How is a retropharyngeal abscess diagnosed?
- Clinical - Soft tissue lateral neck XR - CT neck
26
What is the treatment of a retropharyngeal abscess?
- Airway management - Abx - admission - surgical drainage
27
What is epiglottis?
An infection of the supraglottic structures including the epiglottis, lingual tonsillar area, epiglottis folds, and false vocal cords -EMERGENCY
28
What are the most common etiologies of epiglottis?
HIB, strep, and staph
29
What are the signs and symptoms of epiglottitis?
- Abrupt onset over several hours - fever - strider - toxic appearance - dysphagia - drooling - tripodding - cyanosis
30
What should you never do to a patient with suspected epiglottitis?
Never stick a tongue blade in the throat
31
What sign on XR is indicative of epiglottitis?
Thumb sign
32
What is the treatment of epiglottitis?
- Immediate attention to control and manage the airway - likely surgery - ABX (Cephalosporin)
33
What is croup?
Usually benign, self limited inflammatory condition of the trachea below the level of the vocal cords
34
What is the most common cause of croup?
Parainfluenza
35
What are the signs and symptoms of croup?
- 2-3 day hx of URI - low grade fever - Barking cough, worse at night - stridor - dyspnea
36
How is croup diagnosed?
- Clinically | - PA CXR
37
What CXR finding is indicative of croup?
Steeple sign
38
What is the treatment of croup?
- Nebulized epinephrine | - Steroids (prednisolone or dexamethasone
39
What are the signs and symptoms of whooping cough?
- URI symptoms in the early stage - no fever - paroxysms of coughing in later stage - post tussive emesis
40
What is the gold standard for diagnosing Whooping cough?
Nasopharyngeal swab on special culture media
41
What is bronchiolitis?
A clinical syndrome in infancy characterized by rapid respiration, chest retractions, and wheezing
42
What is the most common cause of bronchiolitis?
RSV
43
When should you order a CXR for bronchiolitis?
-Fever, choking, asymmetric chest exam, respiratory distress, sudden deterioration
44
What are the signs and symptoms of bronchiolitis?
- Rhinorrhea, low grade fever - dyspnea, tachypnea - wheezing - cyanosis - apnea
45
How is bronchiolitis diagnosed?
- CXR (hyperinflated lungs) - Pulse ox shows hypoxia - Viral cultures
46
What is the treatment of bronchiolitis?
- Airway management - mild cases observed at home - oxygen - beta 2 agonist - steroids are NOT indicated
47
What is it called when there are paroxysmal attacks of reversible bronchospasm with mucous plugging and inflammation of the trachiobronchial tree?
Asthma
48
What are the signs and symptoms of asthma?
- progressive dyspnea - chest tightness - wheezing, cough - obvious respiratory distress
49
What is the management of asthma?
- Beta 2 agonist - Steroids (PO or IV- solumedrol) - Anticholinergics
50
How do you treat an acute exacerbation of asthma?
-Stacked SVN treatments with bronchodilators (0.5 cc albuterol in 2.5 cc normal saline, 3 treatments given every 30 minutes
51
What is status asthmaticus?
- FEV1 that does not increase to greater than 40% of the predicted value with treatment - These patients can develop major complications like pneumothorax
52
How is status asthmaticus treated?
- Beta agonists, high dose steroids, oxygen | - Admit
53
What is it called when there is inflammation of the lung caused by infection which causes the alveoli to become filled with pus so air is excluded?
Pneumonia
54
What are the signs and symptoms of pneumonia?
- Fever, cough, and dyspnea - Pleuritic chest pain - respiratory failure
55
How is pneumonia diagnosed?
- CXR | - CBC
56
How can tension pneumothorax be diagnosed on US?
Seashore sign is normal, barcode sign indicated PTX
57
What is it called when there is an breech of the lung surface or chest wall allowing air to enter the pleural cavity, causing the lung to collapse?
Pneumothorax
58
What are the signs and symptoms of PTX?
- Chest Paige on the side of the collapsed lung - dyspnea - occasional cough
59
What is the treatment for a PTX with <15-20% involvement?
Observation only, repeat CXR in 48 hours
60
What is the treatment of a PTX with 20% or greater?
- Needle decompression for tension PTX - Simple aspiration - Tube thoracostomy
61
Where is a chest tube typically placed?
Between the 4th and 5th rib
62
What is dosage of epinephrine for IV and SQ for anaphylaxis if there is severe hypotension?
-IV: 0.3-0.5 mg of 1:10,000 SQ: 0.3-0.5 mg of 1:1,000

Emergency/surg (9 decks)

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