ETT Introducer Difficult Airway Management

Question 0

What equipment is necessary for RGW -assisted intubation?

Answer 0

1) J-Tipped Guide wire (J-wire) 0.035”– 60 cm minimum length. 2) 2 Hemostats 3) Small diameter ETT or ETT introducer

Question 1

What three techniques are used for a difficult airway or traumatically injured airway?

Answer 1

1)Cricothyroid puncture to obtain access 2)high-pressure oxygenation and ventilation (HPOV) 3)retrograde Guide wire- assisted endotracheal integration (RGW)

Question 2

What is the primary purpose of high-pressure oxygenation and ventilation (HPOV)?

Answer 2

Oxygenate patient (not ventilation)

Question 3

What is the life-threatening problem related to loss of upper airway patency?

Answer 3

Hypoxia (not hypercapnia)

Question 4

What is a contraindication for HPOV technique

Answer 4

Complete airway obstruction

Question 5

What equipment is needed for high-pressure oxygenation & ventilation (HPOV) ?

Answer 5

1) High-pressure small diameter oxygen supply tubing 2) Three-way stopcock (turn so that all ports are open) 3) high-pressure oxygen supply connector 4) Oxygen flow meter with nipple Or Anesthesia machine fresh gas outlet with 6mm ETT connector

Question 6

What flow should be set for the HPOV technique?

Answer 6

Flow should be set to flush

Question 7

Equipment that comes in and HPOV-RGW kit?

Answer 7

10 mL syringe with needle Vile lidocaine 2% 14 gauge IV catheter 0.035 flexible J-wire 60 cm longer Hemostats Alcohol prep pads Low compliance oxygen tubing Three-way stopcock Threaded nipple for oxygen flow meter 6 mm ETT connector for anesthesia machine

Question 8

Which practitioner-based error accounts for the greatest percentage of “acute” errors when using HPOV technique

Answer 8

50% account for catheter p lacement not confirmed

Question 9

What practitioner based errors account for the greatest percentage of “intermediate” errors in the HPOV technique

Answer 9

Inadequate oxygenation

Question 11

What is special about the ETT introducer?

Answer 11

it has a lumen to provide HPOV

Question 12

What does HPOV stand for?

Answer 12

High-pressure oxygenation ventilation

Question 13

What is the catheter memory in the distal 2 cm of the ETT introducer?

Answer 13

15 – 30°

Question 14

How do you know that the ETT introducer is in the trachea?

Answer 14

By Tactile feedback. Once the tip of the Introducer is through the glottis you will feel the bump of the tracheal rings.

Question 15

What structure of the glottis must you be able to see in order to use the ETT introducer?

Answer 15

The epiglottis. It is used to lift the body of the epiglottis then slide into the vocal chords

Question 16

What are some complications associated with the ETT introducer

Answer 16

1 Tracheal abrasion 2 Tracheal, laryngeal, or pharyngeal Puncture (Hemorrhage, hematoma, infection, abscess, mediastinitis) 3 Failure to obtain glottic Entry 4 Failure pass endotracheal tube