1: Airway obstruction and tracheostomy

Question 1

Define stridor

Answer 1

High-pitched inspiratory noice caused by obstruction of larynx and large-airways

Question 2

Define stertor

Answer 2

Snoring-type noise produced by obstruction of pharynx

Question 3

Define wheeze

Answer 3

Polyphonic expiratory noice caused by lower airway narrowing

Question 4

What is another sign of airway obstruction

Answer 4

Cyanosis

Question 5

How should airway obstruction be approached

Answer 5

A-E

Question 6

What is the approach for checking airway

Answer 6

Look
Listen
Feel

Question 7

What 4 things are being looked at in airway obstruction

Answer 7

Tracheal Tug
IC Recessions
Cyanosis
RR

Question 8

What is listened for in airway obstruction

Answer 8

Stridor, Stertor

Is patient able to speak in full sentences

Question 9

What is first-line for airway obstruction

Answer 9

Oxygen or heliox

Question 10

What is heliox

Answer 10

Helium and oxygen

Question 11

After giving oxygen in airway obstruction what should be re-assessed

Answer 11

Observations

Question 12

What is then given in airway obstruction

Answer 12

Nebulised adrenaline
Contact anesthatist
Airway adjuvancts

Question 13

What is an endotracheal tube

Answer 13

Tube is inserted into mouth and into trachea

Question 14

What are endotracheal tubes used for

Answer 14

Short or Long-term ventillation

Question 15

What is the problem with endotracheal tubes

Answer 15

Requires paralysis

Question 16

What is emergency needle cricothyroidotomy

Answer 16

Wide bore cannula (14G) is inserted through cricothyroid membrane

Question 17

How long can emergency needle cricothyroidotomy sustain life for

Answer 17

30-45m

Question 18

When is emergency needle cricothyroidotomy used

Answer 18

Upper airway obstruction when endotracheal tube isn’t possible (burns, maxofacial trauma, foreign body)

Question 19

What is a tracheostomy

Answer 19

Surgical incision made in the neck and deepened to the trachea

Question 20

What are the 6 causes of acute stridor

Answer 20

1. Anaphylaxis
2. Foreign Body
3. Burns (Oedema)
4. Laryngitis
5. Epiglottitis
6. Croup

Question 21

What are the 6 causes of chronic stridor

Answer 21

1. Subglottic stenosis
2. Laryngomalacia
3. Vocal cord paralysis
4. Subglottic hemangioma
5. Malignancy

Question 22

What are the indications for endotracheal tube

Answer 22

• Respiratory/Cardiac arrest
• Imminent obstruction
• Unconscious patient can’t breathe

Question 23

What are contraindications of endotracheal tube

Answer 23

C-spine injury
Difficult airway
Severe airway trauma

Question 24

When are nasopharyngeal airways used

Answer 24

Patient is semi-conscious or conscious

Question 25

What are two contraindications to nasopharyngeal airway use

Answer 25

Epistaxis | Nasal trauma

Question 26

When are oropharyngeal airways used

Answer 26

When tongue could compromise airway

Question 27

What are two contraindications of oropharyngeal airway

Answer 27

- Conscious patient (intact GAG reflex) | - Foreign body obstruction pharynx

Question 28

When is a tracheostomy used

Answer 28

- Upper airway obstruction when endotracheal tube is not possible - Epiglottitis - Maxofacial trauma