Module 2 Airways Flashcards
What are the 5 factors that need to be looked at in an airway assessment
- Face
- Mouth
- Teeth
- Neck and range of motion
- Trachea
What are the 4 things to look for in the face in an airway assessment
- Overt tumors
- Congenital deformities
- Facial tumors
- Facial hair
What are the important factors to look at in the mouth 4
- Opening
- Tongue size
- Tumors
- Mallapati score
What are the 3 factors to look at in the neck
- Spinal injuries
- rule
- Range of motion of the neck
What are the 4 D of airway management and what does is mean
- Disproportion
- Distortion
- Dysmotility
- Dentition
They are a measure of the difficulty to intubate a patient
What are the 5 factors the contibute to dispropotion
Macroglossia (big tongue)
Micrognathia (small chin)
High-arched palate
Bony abnormalities
Short thick neck
What are the 3 factors that contribute to distrotion
- Airway trauma
- Epiglottitis
- Laryngeal tumors
What are the 3 factors that contribute to dysmotility
- Limited mouth opening
- Fixed cervical spine
- Spinal injury
What is a 1 and a 4 on the mallampati score
- Completely visualise the uvula
- Cant see the uvula at all
Which airway device provides protection against aspiration
ETT
When is an armoured ETT tube used
When the surgery takes place in a non standard position e.g. prone
When is a south facing ETT used
Facial and eye surgery
Where is the north facing tube inserted and what is it used for
Inserted in the nose and is used for jaw and mouth surgery
What is the curved and the straight bladed laryngoscope called
Curved: Macintosh
Straight: Miller
Where is the tip placed on a macintosh and a miller blade
Mac: In vallecula
Miller: Under eppiglottis
Do LMA protect against aspiration
No
What are the 6 important components of an airway trolley
- ETT
- Masks
- Airways (OPA)
- Introducer
- LMA and laryngioscope
- Suction
Can an awake patient have an OPA
No it will trigger the gag reflex
What is the benifit of an OPA
It can be used in combination with mask ventilation to prevent the tongue blocking the airway
What is the function of a nasopharyngeal airway
It is used to prevent the tongue from obstructing the pharynx
What are the factors that make mask ventilation difficult
M> Seal on the mask
O> Obstructions and obecity
A> Age extremes
N> No teeth
S> Stiff lungs
What are the factors that make an ETT difficult
L> Looks
E> 332 rule
M> Mallapati
O> Obstruction
N> Neck mobility
What are the factors that make a supraglottic airway difficult
R> Restricted mouth opening
O> Obstruction
D> Distortion of anatomy
S> Stiff lungs
What are the factors that make a FON difficult
S> Scars
H> Haematomas
O> Obese
R> Radiotheropy
T> Trauma and tumors
Y> Young patients
At what joint does the neck mobility mainly come from
Atlanto occipital joint
What are the 2 most essencial monitors for airway management
Capnography and Pulse oximetry
What causes a see saw motion of the chest
Complete upper airway obstruction
What are the 2 main disadvantages of tracheal intubation
- It requires muscle relaxants
- It can cause damage to the airway
What is the formula for estimating the size
(Age/4) + 4
What is the rough depth of insertion of an ETT tube
In a man it is 22cm in a women 20 cm and in a child it is (Age/2)+12
What is the best position for intubation of a patient
Sniffing the morining air: This is where the patients neck is flexed lower down and then extended at the Atlanto occipital joint
What is the only reilable way of knowing that the ETT is in the correct place
Continuos square waveforms on the trace of the capnograph
When is the capnography not reliable
- When the tube is placed in one bronchi
- If the tube is in the oropharynx and just the tip is in the vocal cords
What needs to be done to prep for a nasopharyngeal airway
Vasoconstricting nasal drops should be used to prevent bleeding
What is the complication with extabating at too light a level of anaestesia
It can cause a laryngospasm
What size of LMA is appropriate for men and women
Men: 4 or 5
Women: 3 or 4
What are the 3 main indications for an LMA
- As primary airway in a well fasted patient for short prosedures
- Rescue strategy if ETT fails
- In resus
What are the 5 indications for a surgical FON airway
- Prolonged intubation
- Head and neck deformity
- Impossible airway
- Difficulty weaning from the machine
- Emergency airways
