6 - ENT - Upper airway - Obstruction - Emergency airway management Flashcards

1
Q

when would cricothyroidectomy be done

A
  • obstruction is at or above level of larynx, so endotracheal intubation not possible
  • severe maxillofacial trauma
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2
Q

3 dif methods for cricothyroidectomy

A

needle
cricoidotomy kit
surgical

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3
Q

describe needle method of cricothyroidectomy

A

large bore canula into cricothyroid membrane at 45 degrees (sup)
give oxygen through cannula

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4
Q

describe surgical method of cricothyroidectomy

A

usually only >12y

incision in cricothyroid membrane, parting of tissue, insertion of short ET tube

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5
Q

Complications of cricothyroidectomy

A

laryngeal/tracheal trauma
recurrent laryngeal nerve damage
haemorrhage
oesphageal perforation

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6
Q

Indications for a tracheotomy - 6

A
  • bypass UAO
  • prevent UAO due to swelling after H+N surgery
  • prevent aspiration in neuro condition
  • allow respiration following laryngectomy
  • protect lungs from UA bleeding
  • in long term mechanical ventilation
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7
Q

Trachy - role of cuff + fenestration

A

cuff - allows seal for ventilation, prevents aspiration from above level of cuff
fenestration - allows air to pass through on expiration into larynx for speech

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8
Q

Trachy - role of speaking valve + reservoir

A

speaking valve - allows air to enter during inspiration + closes on inspiration
reservoir- allows cuff pressure to be checked

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9
Q

early complications of Trachy

A
blockage
displacement
surgical emphysma
pneumothorax
infection
dysphagia
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10
Q

late complications of Trachy

A

tracheal erosion or stenosis
tracheo oesophageal fistula
persistent tracheocutaneous fistula
tracheitis

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