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Flashcards in Acute Airway failure Deck (14):
1

Causes of acute airway failure?

Depressed level of consciousness
Mechanical obstruction

2

Methods of assessment of acute airway failure

1. airwayfunction - patency
2. compsatory features
3. underlying cause

3

Airway function features

Obstruction: horase voice, stridor, snoring
Soft tissue recession: tracheal tug, rib/abdominal recession
Altered level of consciouness/mental status
Cyanosis low pulse oximeter

4

Compensatory features of partial airway obstruction

SItting up/leaning forward
Reluctance to speak or cough
Increase WOB - nasal flaring, accessory use, pursed lips

5

Reversible causes of airway obstruction

Foreign material
Lip, tongue, palatal swelling
Burns

6

Management

O2
Monitor: ECg, pulse, BP
IV access
Help from senior staff
Reposition patient - sniff morning air position, left lateral position, head tilt/chin lift/ jaw thrust
Clear foreign material
Can put in airway: oropharyngeal (guedel), nasopharyngeal, LMA

7

What is common cause of acute airway failure

Angiodema
Anaphylaxis

8

What are the clinical manifestations of anaphylaxis?

Airway: laryngeal oedema - hoarseness, stridor
Respiratory: cough, excess secretions, bronchospasm, rhinitis, conjunctivitis
Circulatory: tach, brady, vasodilation - hypotension - shock
Other manifestations: cramps/pain, vomit, diarrhoea
Skin: erythema, urticaria

9

Management for mild anaphylaxis!

Mild anaphylaxis: skin manifestations +/- mild angiodema
1. Remove allergen
2. Give oral antihistamines
3. Give pred 50 mg and ranitdine 150 PO
4. No response, treat as moderate

10

Moderate anaphylaxis Mx!

1. O2 >95%
2. 0.01mg/kg adrenaline IM up to 0.5 into lateral thigh
3. Monitor
4. IV access
5. No response = SEVERE

11

Severe anaphylaxis Mx!

1. IM adrenaline 0.01mg/kg
2. IV access large bore!
3. 1 mg of adrenaine in 100 ml of saline and admin at 1mL/kg/Hr or repeat IM adrenaline

12

What happens if laryngeal oedema?

give 1:1000 adrenaline 5 mg nebulized with oxygen and prep for surgical airway

13

What happens if wheeze/history of asthma?

Give hydrocortisone 200 mg IV, nebulized salbumtamol 5 mg and repeat continuously !

14

What happens if hypotension?

Lay patient supine and elevate legs
Saline bolus 20mL/kg IV q30mins
Give atropine
Consider other vasopressors!