Primary Survey - Airway Flashcards
(25 cards)
Predicting a difficult airway
H - History of previous airway difficulties
A - Anatomical abnormalities of the face
V - Visual clues (obesity, facial hair etc)
N - Neck immobility
O - Opening of the mouth (<3 fingers)
T - Trauma
Predicting difficult mask ventilation
M - Mask seal issues
O - Obesity, obstructed airway
A - Age >55 years
N - No teeth
S - Stiff lungs
Predicting difficult SGA insertion and ventilation
R - Restricted mouth opening (<3 fingers)
O - Obstruction at the larynx or below
D - Distorted airway
S - Stiff cervical spine / Stiff lungs
Predicting difficult cricothyroidotomy
S - Surgery/Scars/Short neck
H - Haematoma
O - Obesity/Oedema
R - Radiotherapy
T - Trauma/Tumor
OPA sizes
000 - neonate
00 - infant
0 - small child
1 - child
2 - small adult
3 - medium adult
4 - large adult
PHEA Drugs - Ketamine
Drug type:
NMDA receptor antagonist
Indication: induction & maintenance of anaesthesia
Dose:
Induction 1-2mg/kg
Maintenance 0.5-2.5 mg/kg/hr
Advantages:
Haemodynamically stable
Bronchodilation
Ventilation and airway reflexes maintained
Disadvantages:
Tachycardia
Hypertension
Increased salivation
Emergence
PHEA drugs - Propofol
Indication: induction & maintenance of anesthesia
Dose:
induction - 0.5-2mg/kg
Maintenance - 1-5 mg/kg/hr
Advantages:
Rapid and clear loss of awareness
Reduces ICP
Anticonvulsant
Disadvantages:
Can cause catastrophic haemodynamic collapse in the unstable patient
Cormack-Lehane grade 1
Full view of the glottis
Cormack-Lehane grade 2a
Partial view of the glottis
Cormack-Lehane grade 2b
Arytenoids or posterior part of the vocal cords only just visible
Cormack-Lehane grade 3
Only epiglottis visible
Cormack-Lehane grade 4
Neither glottis, not epiglottis visible
Measurement of an OPA
Patients incisors to angle of the jaw
Common RSI drugs in the UK are
Ketamine Fentanyl Rocyronium
DOPES stands for
Displacement
Obstruction
Pneumothorax
Equipment failure
Secretions
HAVNOT can be used to predict a difficult airway, it stands for?
History of airway difficulty
Anatomical abnormality
Visual clues e.g. facial hair
Neck immobility
Opening of mouth < 3 fingers
Trauma
In children under 8, what type of surgical airway is indicated if no ENT experience?
Needle cric
In peads, what should the initial flow rate for the needle critic be? And at what ratio do you ventilate
1L per yr of age (titrate up in 1L increments if no chest rise seen). Ratio of 1sec on, 4 secs off
Indications for PHEA
Airway compromise
Respiratory failure
Unconsciousness
Agitated head injury (GCS <14)
?Humanitarian reasons
Expected clinical course
Optimal conditions for ETI are produced by using what three types of drugs
anaesthetic agent with or without an opiate
Neuromuscular blocker
PHEA and PPV can do what to hemodynamic instability
Worsen it
SHORT predicts a difficult surgical airway, it stands for?
Surgery/ scar/ short neck
Hematoma
Obesity
Radiotherapy
Trauma
suctioning the airway with a Yankauer catheter be for no longer than that?
15 seconds
The difficult airway society have ….. the use of needle or cannula cricothyroidotomy in adults
Stopped recommending
