SUPPLEMENTAL INFO FROM WATSON Flashcards
What is the central focus of airway management?
Tracheal intubation (TI)
TI methods include direct laryngoscopy, flexible intubating scope, intubating laryngeal mask airway, and videolaryngoscopy.
What factors influence the choice of intubation technique?
Factors include:
* Patient’s history and physical airway assessment
* Previous anesthetic history
* Risk factors suggesting a challenging airway
What is the Sniffing Position?
Flex the neck and extend at the atlantooccipital joint to align the oral, pharyngeal, and tracheal axes
Achieved with pillows, blankets, towels, or OR table adjustments.
What technique is used for Preoxygenation?
100% O₂ for 3–5 minutes at normal tidal volumes with a tight mask seal and ≥5 L/min fresh gas flow
Monitor for visible bag movement, defined end-tidal CO₂ waveform, and F_EO₂ ≥90%.
What does the acronym BURP stand for in laryngoscopy?
Backwards-Upwards-Rightwards-Pressure
This technique can improve visualization during laryngoscopy.
What should be the immediate focus during a difficult or failed intubation?
Ensure adequate oxygenation and ventilation
Use adjuncts like flexible intubating scope or videolaryngoscope.
What defines a Difficult Airway?
Difficulty with any of the following:
* Facemask ventilation
* Supraglottic airway placement
* Endotracheal intubation
* Invasive airway (cricothyrotomy)
What are signs of a Difficult Airway during facemask ventilation?
Signs include:
* Significant leak
* Poor chest rise
* Absent breath sounds
* Gastric air entry
* Poor CO₂ waveform
* Pulse oximetry <92% on 100% O₂
What is the first question in the Airway Approach Algorithm?
Is airway management necessary?
What is the primary goal of awake intubation?
Maintain spontaneous ventilation
Techniques include videolaryngoscopy or a flexible intubating endoscope.
What is the role of sedation in awake intubation?
Minimal doses of sedatives may be used
Over-sedation can lead to respiratory depression and loss of airway reflexes.
What is the technique for a Glossopharyngeal Nerve Block?
- Topically anesthetize the tongue.
- Insert a needle at the palatoglossal arch.
- Inject 1–2 mL of 2% lidocaine.
Fill in the blank: The technique for a Transtracheal Block involves identifying the _______.
cricothyroid membrane
What are the practical tips for awake intubation?
Tips include:
* Time and cooperation are essential
* Avoid over-sedation
* Confirm safe total local anesthetic dose
* Prepare backup plans
True or False: The ASA Difficult Airway Algorithm recommends waking the patient if intubation is difficult.
true
It recommends working in a stepwise progression instead.
What is the purpose of effective preoxygenation?
Maximizes safe apnea time
What should be prepared in case of unexpected failed airway?
Shift to a difficult-airway management strategy immediately
This may occur without external signs of difficulty.
List the techniques for awake intubation.
Techniques include:
* Awake Laryngoscopy
* Flexible Intubating Endoscope
What is the benefit of a Flexible Intubating Endoscope?
Allows for preload of an endotracheal tube over the endoscope
Can be passed orally or nasally.
What is the role of local anesthetic agents in airway blocks?
Used to achieve airway anesthesia
Agents include lidocaine, cocaine, or benzocaine.
What is the significance of the Cormack-Lehane grading system?
Used to assess the glottic view during laryngoscopy
Grades III or IV indicate a difficult intubation.
