Lecture 13: Airway Management

Question 1

What is the purpose of endotracheal tube

Answer 1

1.provide positive pressure ventilation
2. Deliver inhalant
3. Deliver O2
4. Protect airway-avoid aspiration pneumonia

Question 2

What species are obligate nose breathers

Answer 2

Rabbits, horses

Question 3

What is insufflation

Answer 3

System in which gases are delivered directly to patients airway in the absence of valves, reservoir bag, or carbon dioxide absorption

Question 4

Insufflation is only used to supplement ___

Answer 4

Oxygen

Question 5

What is the equipment needed for insufflation

Answer 5

Nasal cannula, face mask, O2 line connected to large bore IV catheter going through trachea

Question 6

What is a mask used for

Answer 6

Pre-oxygenation and respiratory distress

Question 7

What is better: flow by or face mask for oxygenation

Answer 7

Face mask

Question 8

What are some pros for oxygen cages

Answer 8

Patient behavior, free mobility, control humidity and temp, short term

Question 9

What are some cons of oxygen cages

Answer 9

FiO2 up to 30-60%, expensive, long filling time, difficult to control humidity and temp with large breeds, FiO2 decreases when cage opened, not practice for large animals

Question 10

What are guarded ET tubes used for

Answer 10

Prevent airway obstruction/kink

Question 11

How do you find correct ET tube size

Answer 11

Measure from manubrium to tip of nose

Question 12

If the ET tube is too long what will happen

Answer 12

Incensed dead space

Question 13

If ET tube is too short what will happen

Answer 13

Leak and increased airway resistance

Question 14

what’s wrong with this invitation

Answer 14

One lung intubation

Question 15

Why do we use cuffed ET tubes

Answer 15

1. Prevent aspiration pneumonia
2. Seals airway for ventilation

Question 16

What happens with under inflation and over inflation of cuff

Answer 16

Under: aspiration pneumonia
Over: necrosis of tracheal mucosa

Question 17

___cuff for extubation

Answer 17

Deflate

Question 18

What is a challenge when intubating cats and what is solution

Answer 18

Laryngeal hyper-responsiveness to mechanical stimulation

Desensitize larynx with lidocaine spray

Question 19

What 5 things make for a challenging intubation in brachycephalics

Answer 19

1. Narrow rima glottis
2. Everted laryngeal saccules
3. Elongated soft palate
4. Enlarged tonsils
5. Hypoplastic trachea

Question 20

Why do you use lidocaine spray vs benzocaine for cat intubation

Answer 20

Benzocaine causes methemoglobinemia

Question 21

What are some important things for brachycephalic extubation

Answer 21

1. Keep ET tube in as long as possible
2. Have laryngoscope available
3. Have anesthesia induction agent available
4. ET tube available
5. Do not hesitate to re-intubate

Question 22

If reintubation necessary what 4 things are important

Answer 22

1. Mannitol
2. Dexamethasone
3. Time
4. Sedatives

Question 23

How do you confirm ET intubation

Answer 23

1. Capnography- best practice
2. Direct auscultation of the ET tube during expiration
3. Condensation inside ET tube
4. Fogging of glass in front of ET tube

Question 24

What this and what is normal value

Answer 24

ETCO2
Normal:35-45

Question 25

What wrong

Answer 25

esophageal intubation

Question 26

what wrong

Answer 26

Airway obstruction

Question 27

What wrong

Answer 27

air leakage

Question 28

What species do we not used cuffed ET tubes

Answer 28

Birds, no trachealis muscle

Question 29

What can we use to intubate rats, mice or other small animals

Answer 29

IV catheter or red rubber

Question 30

What species has intubation done blindly

Answer 30

Equine

Question 31

What species have a pharyngeal diverticulum

Answer 31

Swine