RRAPID: A

Question 1

Airway recognition

Answer 1

Look - for chest movements, use of accessory muscles
Listen - Abnormal sounds?
Feel - airflow on inspiration + expiration

Question 2

Airway management

Answer 2

Management:
Call for help
O2 15L via non-rebreathe mask
Head tilt chin lift
Remove foreign bodies/ suction secretions
Airway adjuncts
Ventilate using bag + mask if patient not breathing

Question 3

How to assess hypotensive pt?

Answer 3

Assess:
HR - is HR causing the hypotension (arrhythmia)
Volume status
Cardiac performance - MI? myocarditis?
Systemic vascular resistance - sepsis, anaphylaxis?

Question 4

Causes of airway obstruction

Answer 4

Reduced consciousness
Foreign bodies
Secretions
Swelling (infection, anaphylaxis)

Question 5

Clinical presentation + causes of airway obstruction

Answer 5

Snoring - pharynx is partially obstructed by soft palate/ tongue
Choking
Gurgling noises - due to secretions
Stridor - harsh high pitched noise on inspiration due to turbulent flow
Silent if its complete
See-saw movement of abdo + chest due to inspiratory effort against closed airway

Question 6

What is paradoxical breathing?

Answer 6

See saw movement of abdo and chest
Abdomen moves out as diaphragm moves down but negative pressure generated against the obstructed airways draws chest inwards

Question 7

Describe an oropharyngeal airway - when is it used, what sizes and how to measure size, when to use with caution?

Answer 7

Guedel airway
Used for unconscious patients to overcome soft palate obstruction by preventing backward displacement of tongue
Available in sizes 2-4
Measure size from vertical distance from patients incisors + angle of jaw
Caution in pts that are only lightly unconscious

Question 8

Describe how a nasapharyngeal airway is inserted + what it looks like?

Answer 8

Made from soft plastic, bevelled at one end + flanged at other
Inserted through nose, perpendicular to hard palate with twisting action until tip lies in posterior pharynx

Question 9

When is a nasapharyngeal airway useful + when is it contraindicated?

Answer 9

Better tolerated for more conscious patients
High incidence of bleeding so only use when oro airway is not tolerated
Useful in patients whose mouth can’t be opened (ie in seizures)
Contraindicated in pts with skull base fractures

Question 10

What is a laryngeal mark airway?

Answer 10

Wide bore tube with elliptical inflated cuff which forms a seal around laryngeal opening
Only used for deeply unconscious/ anaesthetised pts

Question 11

How to use a bag + mask to ventilate?

Answer 11

Self inflating AMBU bag connected to mask

Squeeze bag at rate of 10-12 per minute

Question 12

When is a definitive airway indicated?

Answer 12

GCS <8 or rapidly falling LOC

Question 13

Causes of airway obstruction

Answer 13

CNS depression 
Foreign body 
Trauma 
Blocked tracheostomy 
Swelling (infection/ oedema)
Laryngospasm, bronchospasm

Question 14

How does airway obstruction kill?

Answer 14

Cerebral oedema 
Pulmonary oedema 
Exhaustion 
Hypoxic brain injury 
Secondary apnoeas