Advanced Airway Management

Question 1

List 2 types of advanced airway? (2)

Answer 1

• ET intubation
• Surgical cricothyroidotomy

Question 2

What are the indications for using an advanced airway?

Answer 2

• Protect airway from obstruction
• Control oxygenation and ventilation
• Inability to clear/maintain airway using simple techniques

Question 3

Describe the ET intubation process (1)

Answer 3

ET intubation involves the passing of a cuffed endoracheal tube through the vocal cords and into the trachea

Question 4

What are the indications for ET intubation? (5)

Answer 4

With no anaesthetic,
- deeply unconscious casualty
- management of cardiac arrest

With anaesthetic,
- Casualty transfer
- Pre-empt potential airway obstruction
- Management of head and chest injuries

Question 5

What are the contra-indications of ET intubation? (4)

Answer 5

• Trismus
• Trauma
• Shape
• Pre-existing disease

Question 6

What are the potential complications of ET intubation? (7)

Answer 6

• Hypoxia
• Failed intubation
• Spinal cord injury
• Damage to teeth, mouth or larynx
• Laryngeal spasm
• Oesophageal intubation
• Intubation of the right bronchus

Question 7

What is surgical cricothyroidotomy (1)

Answer 7

Surgical cricothyroidotomy is the placement of a small cuffed tracheostomy tube into trachea via an incision into the cricothyroid membrane

Question 8

What are the indications for a surgical cricothyroidotomy (3)

Answer 8

• Trauma/burns to face/neck which prevent intubation
• Concious casualty
• Total upper airway obstruction

Question 9

What are the potential complications of a surgical cricothyroidotomy (6)

Answer 9

• Damage to the carotid arteries
• Bleeding
• Creation of a false passage into the tissues
• Asphyxia
• Aspiration of blood
• Laceration of trachea/oesophagus