A - Airway

Question 1

If you suspect a patient is at high risk of vomiting and needs intubation what can you do to minimise risk

Answer 1

suction
prepare to log roll
NGT
Put in ET tube

Question 2

How can blunt trauma to the neck affect airway

Answer 2

haemorraghe can cause obstruction

Question 3

A patient presents after an RTC wearing a seatbelt, they have a hoarse voice, subcutaneous emysema around the neck and a palpable bony fragment on the neck

what may be the Dx

Answer 3

Laryngeal #

Question 4

How do you assess the airway and assess difficulty of intubation

Answer 4

inspect and palpate madible
look inside mouth
palpate neck area

LEMON
Look
Evalate 332 rule
Malampti score
Obstructions
Neck mobility

Question 5

When is RSI indicated

Answer 5

individuals with risky intubation in terms of vomiting / having intact gag reflex

Head injuries

Question 6

Why is an RSI risky in difficult airways

Answer 6

paralysis of muscles may make intubation harder

Question 7

When is a surgical airway indicated

Answer 7

oedema of glottis
laryngeal #
severe oropharyngeal haemorraghe
failure to place ET

Question 8

What are life threatning injuries associated with A

Answer 8

laryngeal injury
posterior disclocation of clavicular head
other causes ofobstruction (inc. cest)
tracheobronchial tree injury

Question 9

A patient who was desaturating after chest trauma had a chest drain inserted, you notice increased bubbling and continued air leak.
On exam you hear diminised L sided breath sounds

what may have happened

Answer 9

tracheobroncheal injury

Question 10

If you suspect tracheobronchial injry what may differ in your approach / consideration of intubation

Answer 10

selective intibation and if needed with fiber optic guidance/visualisatio

Question 11

how would you diagnose tracheobroncheal injury definitively

Answer 11

bronchoscopy

Question 12

where anatomically is tracheobronchial injury likely to have occured

Answer 12

2cm / inch of the carina