ENT

Question 1

What is normal IOP?

Answer 1

12-16 mmHg

Question 2

Can succinylcholine be given with an open globe injury?

Answer 2

controversial, it increases IOP 6-8 mmHg (similar to blinking)

Question 3

Why shouldn’t etomidate be given for an open globe injury? Ketamine?

Answer 3

etomidate: risk of generalized myclonus raising IOP
ketamine: nystagmus and blepharospasm

**stick with propofol**

Question 4

How can you minimize coughing on emergence?

Answer 4

deep extubation (risky with full stomach)

suction prior to reversal of NMBs

lidocaine or remifentanil bolus

Question 5

What is the surgical treatment for recurrent respiratory papillomatosis (RRP)?

Answer 5

recurrent debridement with a CO₂ laser or microdebrider

Question 6

What should be done in the event of an airway fire?

Answer 6

“The 4 E’s”

Eliminate oxygen: disconnect from circuit

Extract: remove ETT and combustible materials

Extinguish: flood with saline

Evaluate: likely reintubate

Question 7

How can the airway be managed for jet ventilation?

Answer 7

induction and placement of rigid scope if no need for airway evaluation

intubation, then evaluation with rigid scope, ETT can be removed and jet ventilation begun if appropriate

Question 8

What are the options for airway managemnet for laryngeal papilloma resection?

Answer 8

jet ventilation

small ETT

spontaneous ventilation under GA (no ETT)

intermittent apnea under GA (no or intermittent ETT)