Laryngospasm

Question 1

what are the complications of laryngospasm

Answer 1

negative pressure pulmonary edema, airway obstruction, pulmonary aspiration of gastric contents, cardiac dysrhythmias, cardiac arrest, and death

Question 2

signs of laryngospasm

Answer 2

• inspiratory stridor
• surprasternal and supraclavicular retraction
• rocking horse appearance of chest wall
• increased diaphragmatic excursion
• lower rib flailing
• absent or altertered CO2 waveform

Question 3

pre-anesthetic risk factors for laryngospasm

Answer 3

• active or recent URI (<2weeks)
• expsoure to secondhand smoke
• reactive airway disease
• GERD
• age < 1 year

Question 4

Risks for laryngospasm while in the OR

Answer 4

• light anesthesia
• saliva or blood in the airway
• hyperventilation / hypocapnia
• airway surgical procedures (tonsils, bronchitis, nasal/sinus, palat, adenoids, etc etc)

Question 5

how to reduce risk for laryngospasm

Answer 5

• avoid airway manipulation during light anesthesia
• CPAP 5-10cmH20 during inhalation induction
• tracheal extubation when deep or fully awake
• remove pharyngeal secretions
• laryngeal lidocaine
• IV lidocaine before extubation

Question 6

What do you call the maneuver where you exhale against a closed glottis

Answer 6

Valsalva’s maneuver

Question 6

Treatment for laryngospasm

Answer 6

1. 100% FiO2
2. suction
3. CPAP 15-20cmH20 with larsons maneuver
4. deepen anesthesia with propofol, lidocaine, or gas
5. IV succinylcholine
6. IM succhinycholine 5mg/kg for kids or 4mg/kg for adults
7. Atropine with succ in kids liess than 5yo to prevent bradycardia dose: 0.02 mg/kg

Question 7

What maneuver is inhalation against a closed glottis

Answer 7

Mullers maneuver

negative pressure pulmonary edema