Larynx Conditions + Airway Management

Question 1

What are 3 ways Laryngitis presents?

Can be infectious, usually self limiting and resolves in 2-3 weeks

Answer 1

• Hoarse/ weak voice
• Sore throat
• History URT Infection

Question 2

What are 2 types of causes of Laryngeal Nodules? (Benign growths on the vocal cords)

How can they present?

Answer 2

• Acute trauma or chronic irritation
• Hoarse voice >3 weeks

(Requires visualisation of cords and/ or biopsy)

Question 3

Suggest 5 ways someone with a compromised upper airway may present

Answer 3

• Stridor
• Raised RR
• Distress
• Hypoxia
• Possible Cyanosis

Question 5

What is Epiglottitis?

Answer 5

Inflammation, due to infection (often H. Influenzae B), causing swelling of Epiglottis and Supraglottic tissues

Question 6

Other than those of a compromised Upper airway, what symptoms may someone with Epiglottitis present with?

Answer 6

• Pooling of saliva + drooling
• High fever, sore throat

Attempts to keep airway as patent as possible;

• Sitting up
• ‘Sniffing position’ (Slight extension of head at neck)

Question 7

Should children with Epiglottitis have their throat examined? (Mostly affects infants aged 2-6)

What are 3 methods of treatment?

Answer 7

No, as it can lead to deterioration in their symptoms as even less air can get in

• Tracheotomy
• Intubation
• HiB Vaccine

Question 8

Croup often occurs in children aged 6 months to 3 years.

How can it be treated?

Answer 8

• Calming infant (crying exacerbates symptoms)

- Sitting up and injecting corticosteroid medication

Question 9

Airway management can be Planned or an Emergency.

List 2 Simple Airway manoeuvres
List 2 Airway Adjuncts

Answer 9

• Head tilt Chin lift
• Jaw thrust
• Oropharyngeal airway (Guedel)
• Nasopharyngeal

Question 10

Describe use of a Supraglottic Airway (E.g iGel)

Answer 10

• Maintains airway and affords some protection from secretions/ vomit
• Minimal technical skills needed
• Often 1st line in cardiac arrest
• Not for long-term ventilation

Question 11

Describe use of a Definitive Airway/ Intubation (E.g ET Tube)

Answer 11

• Technical skill needed + use of laryngoscope
• Secures and protects LRT from secretions and Vomit
• Patient anaesthetised prior to insertion

Question 12

List 3 conditions that can present an immediate threat to the airway

Answer 12

• Laryngeal Oedema (Due to allergy or foreign body swallowing)
• Epiglottitis (Rare, can be severe)
• Croup (Common, not usually severe, viral, ‘Barking cough’ made worse by agitation)