Exam 2 Airway Equipment II [6/27/24] Flashcards
Describe a Shikani Optical Stylet.
- Stainless steel lighted stylet with a malleable distal tip
- Design utilizes an eyepiece for DL
- Oxygen port for oxygen insufflation
S43
What kind of position will the patient have for a Shikani Optical Stylet?
- Neutral Position
- Stylet Inserted Midline
- available ins adult and peds sizes
S43
How is the Shikani Optical Stylet inserted?
- advance into the trachea with light pressure
- tip should remain anterior [pointed up] at all times to avoid injury.
S43
Shikani Optical Stylet can be used for what?
- can be used as a light wand
- check ETT placement
- or placement of double-lumen ETT
S43
Advantages of the Shikani Optical Stylet
- Easy to use for routine and difficult intubations
- Trachea is visualized. Esophageal intubation should not occur
- Decreased incidence of sore throat
- Results in less C-spine movement over conventional laryngoscopy
Timeout for a SEC! lets list the advantages of shikani
S44
Disadvantages of the Shikani Optical Stylet
- Longer intubation time
- Cannot be used with nasal intubation. (not flexible)
- Cannot be adjusted into a precise direction compared to a traditional malleable stylet
S44
Name the four most common Video Laryngoscopes.
- Glidescope
- Co-Pilot
- King
- McGrath
S45
What are the advantages of using a video laryngoscope?
- Magnified anatomy
- Some scopes have curved/straight blades to mimic laryngoscopes
- Operator and assistant can see
- May result in decreased c-spine movement
- Further distance from infectious patients
- Demonstrates correct technique in legal cases
laryngoscopes Magnify Some Of My Flawed Doctors
S45
What are the limitations of using a video laryngoscope?
- Requires video system
- Portability varies (Glidescope needs to be plugged in)
S45
What is the strongest predictor of failure when using a video laryngoscope?
- Altered neck anatomy with the presence of a surgical scar, radiation changes, or mass
S45
Complications of Laryngoscopy
- Dental Injuries
- Cervical Spinal Cord Injury
- Damage to other structures:
- Abrasions/Hematoma
- Lingual/ Hypoglossal nerve injury
- Arytenoid Subluxation
- Anterior TMJ dislocation
- Swallowing of foreign body (lightbulbs, teeth)
Laryngoscopy Complications SAAAD
S47-48
What is the most frequent anesthesia-related claim?
- Dental Injury
S47
What is most likely damaged during laryngoscopy?
- Upper incisors
- Restored or weakened teeth
S47
- where are tooth protectors placed to mitigate laryngoscopy-related dental injury?
- what does it protect?
- does it guarantee safety from dental trauma?
- placed on upper teeth during DL
- Protects from blade causing direct surface damage
- Does not guarantee safety from dental trauma
S47
What two teeth have the highest incidence of dental injuries?
Left Central Incisor (47%)
Left Lateral Incisor (20%)
recall info from health assessment
How do you prevent cervical spinal cord injury during a laryngoscopy?
- Do not aggressively position the head
- Manual in-line stabilization (remove C-collar before intubation, have neurosurgeon remove C-collar)
S48
how do abrasions/hematomas occur as a complication of laryngoscopy?
- upper lip gets pinched between teeth and blade.
S48 lecture
- how do lingual &/or hypoglossal nerve injury occur as a complication of laryngoscopy
- due to placing the blade and hitting soft tissue. so, go in slowly, recognize all the structure. Dont be forceful.
S48- lecture
- What is arytenoid subluxation as a complication of laryngoscopy?
- How do we prevent?
- Arytenoid subluxation or dislocation is a rare laryngeal injury that occurs as a result of airway instrumentation or direct trauma to the cricoarytenoid joint, leading to the partial (subluxation) or total (dislocation) displacement of the arytenoid cartilage within the cricoarytenoid joint.
- dont hit the aryenoid with the blade
S48- lecture/looked up on our friend Google
If pt has TMJ what should we NOT do?
- if pt has TMJ, dont force the mouth open can cause anterior TMJ dislocation
S48-lecture
How many teeth does a healthy adult patient have?
- 32 teeth
S49
What ETT properties will contribute to the change in resistance in the breathing system?
- Internal Diameter of the tube
- Tube Length
- Configuration changes (if tube knots up)
- Connectors
S51
What is the most important factor in determining resistat to gas flow?
- internal diameter of tube
- as ID changes & adding more connections = ↑ in resistance
S51- lecture
How does tube length change resistance?
- short tube = ↓ resistance
- long tube = ↑ resistance
S51 lecture