Emergency Airway Management Quiz
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Questions and Answers

What can lead to airway obstruction in a patient with decreased level of consciousness?

  • Increased muscle flexibility
  • Strengthening of the epiglottis
  • Loss of pharyngeal tone (correct)
  • Enlargement of the airway passage

    • What is the purpose of an oropharyngeal airway?

  • To maintain the patency of the upper airway (correct)
  • To assist with breathing through the nose
  • To provide oxygen directly to the lungs
  • To prevent aspiration into the stomach

    • Which type of oropharyngeal airway is mentioned as the most common?

  • Guedel airway (correct)
  • Nasopharyngeal airway
  • Endotracheal tube
  • Laryngeal mask airway

    • What sizes are available for the Guedel airway?

    <p>'000' to the largest '9'</p> Signup and view all the answers

    What is the purpose of the nasopharyngeal airway?

    <p>To maintain an open airway when the oral route is not possible</p> Signup and view all the answers

    What does the distal end of the nasopharyngeal airway include?

    <p>A 'safety pin' to prevent migration into the nose</p> Signup and view all the answers

    When is the nasopharyngeal airway considered an alternative to the oropharyngeal airway?

    <p>When the mouth cannot be opened or an oral airway does not alleviate obstruction</p> Signup and view all the answers

    What procedure can be performed using a catheter passed through the nasal airway?

    <p>Nasotracheal suction</p> Signup and view all the answers

    How is the nasopharyngeal airway tolerated by semi-awake patients compared to oral airways?

    <p>Better tolerated</p> Signup and view all the answers

    What is used to facilitate insertion of the nasopharyngeal airway?

    <p>Lubricant</p> Signup and view all the answers

    For an average height female, what is the estimated size for a nasopharyngeal airway?

    <p>Size 6</p> Signup and view all the answers

    For an average height male, what is the estimated size for a nasopharyngeal airway?

    <p>Size 7</p> Signup and view all the answers

    In which of these conditions is the use of nasopharyngeal airway not recommended?

    <p>Bleeding disorders</p> Signup and view all the answers

    What should be avoided during insertion of a nasopharyngeal airway?

    <p>Excessive force</p> Signup and view all the answers

    Why is proper sizing crucial for a nasopharyngeal airway?

    <p>Oversized airway can cause nasal mucosa pressure necrosis, while an undersized one may be ineffective at relieving airway obstruction.</p> Signup and view all the answers

    What is the maximum seal pressure for the LMA-Supreme using the LMA-Proseal?

    <p>30-35 cm H2O</p> Signup and view all the answers

    What technique do some anesthetists use to facilitate easier insertion of the LMA-Supreme?

    <p>Partial inflation of the cuff before insertion</p> Signup and view all the answers

    What is the purpose of the reinforced version of the LMA?

    <p>To aid in head and neck surgery</p> Signup and view all the answers

    What is the Intubating Laryngeal Mask Airway (ILMA) designed to minimize?

    <p>Head and neck manipulation requirements</p> Signup and view all the answers

    What makes LMAs suitable for long procedures using spontaneous ventilation?

    <p>Large internal diameters</p> Signup and view all the answers

    What does the deflation and lubrication of the LMA-Supreme cuff before use help with?

    <p>Reducing gas leakage during ventilation</p> Signup and view all the answers

    What can the LMA be used for in difficult intubations?

    <p>Guiding a narrow lumen tracheal tube into the trachea</p> Signup and view all the answers

    What is the main advantage of ILMA over traditional LMAs?

    <p>Minimizes head and neck manipulation requirements</p> Signup and view all the answers

    What does partial inflation of the cuff before insertion help with?

    <p>Facilitates easier insertion</p> Signup and view all the answers

    Why is the reinforced version of LMA less suitable for prolonged periods of spontaneous ventilation?

    <p>Smaller internal diameters and longer lengths</p> Signup and view all the answers

    What does ILMA aim to simplify?

    <p>Blind or fiberoptic intubation</p> Signup and view all the answers

    What is the purpose of the flange at the oral end of oropharyngeal airways?

    <p>To prevent falling back into the mouth</p> Signup and view all the answers

    What is the material of the bite portion of oropharyngeal airways?

    <p>Straight and hard plastic</p> Signup and view all the answers

    How is Guedel airway size determined?

    <p>By the distance from the patient's incisors to the angle of the mandible or the corner of the mouth to the tragus</p> Signup and view all the answers

    What is a feature of Bermann airway?

    <p>It has a side opening for removal from fiberscope prior to tracheal tube insertion</p> Signup and view all the answers

    What are potential problems associated with oropharyngeal airways?

    <p>Trauma to tissues during insertion, trauma to teeth if patient bites, inducing gag reflex, no protection against aspiration</p> Signup and view all the answers

    What distinguishes a nasopharyngeal airway from an oropharyngeal airway?

    <p>It bypasses the mouth and oropharynx and is inserted through the nose into the nasopharynx</p> Signup and view all the answers

    What is the purpose of the black line present on the laryngeal mask tube?

    <p>To assess its orientation when inserted</p> Signup and view all the answers

    What is a potential problem with using cricoid pressure in relation to the laryngeal mask?

    <p>It may prevent correct placement of the laryngeal mask</p> Signup and view all the answers

    What is a safety feature of the i-gel airway design?

    <p>Epiglottic blocking ridge to reduce the risk of epiglottis downfolding</p> Signup and view all the answers

    What distinguishes the i-gel airway from the laryngeal mask in terms of material and structure?

    <p>The i-gel airway has a non-inflatable gel-like cuff, while the laryngeal mask has an inflatable cuff</p> Signup and view all the answers

    What does the gastric channel in the i-gel airway allow for?

    <p>Direct suctioning or passage of a gastric tube</p> Signup and view all the answers

    Which patient condition is the i-gel airway intended for use with?

    <p>Fasted patients</p> Signup and view all the answers

    What is the purpose of the pilot balloon and self-sealing valve in the laryngeal mask?

    <p>To allow for inflation of the cuff at the distal end</p> Signup and view all the answers

    What is the main advantage of the LMA ProSeal over standard laryngeal masks?

    <p>It allows for blind passage of an orogastric tube</p> Signup and view all the answers

    What can a well-placed laryngeal mask act as in difficult situations such as 'can't intubate, can't ventilate'?

    <p>A conduit for oral intubation</p> Signup and view all the answers

    What is one reason why laryngeal masks should not be used in patients with full stomas or those prone to reflux?

    <p>They provide little or no protection against aspiration</p> Signup and view all the answers

    What is a potential benefit of applying negative pressure or intermittent positive pressure on the laryngeal mask cuff?

    <p>Prevention of air leaks around the cuff</p> Signup and view all the answers

    What is the purpose of integrating a bite block with laryngeal masks?

    <p>To prevent biting on the laryngeal mask</p> Signup and view all the answers

    Study Notes

    • Fiberscope procedure involves inserting a laryngeal mask and then a ramie tube through a sound insulated tube for fiberoptic examination.

    • Problems with the laryngeal mask in practice and safety features.

      • Does not protect against aspiration of gastric contents.
      • About 10% of patients develop airway obstruction due to epiglottis downfolding.
      • Manufacturers recommend using it for a maximum of 40 times, as the cuff is likely to perish after autoclaving.
      • Rotation of the laryngeal mask may result in complete airway obstruction.
      • Black line present on the tube to assess its orientation when inserted.
      • Cricoid pressure may prevent correct placement of the laryngeal mask.

    • The i-gel airway is a single-use extraglottic airway with a mask designed to fit the perilaryngeal and hypopharyngeal structures without an inflatable cuff.

      • Large lumen for ventilation and a proximally placed non-inflatable gel-like cuff with a ridge at the superior anterior edge.
      • Two separate ventilation and gastric channels positioned in the upper esophagus.
      • Wide oval body to prevent rotation and act as an integral bite block.
      • Epiglottic blocking ridge to reduce the risk of epiglottis downfolding.
      • Available in adult, pediatric, and neonatal sizes.
      • Intended for use with fasted patients, both spontaneous and controlled ventilation, and can be used as a conduit for tracheal intubation.
      • Mechanism of action:
        • Soft, gel-like plastic allows it to mold without an inflatable cuff.
        • Gastric channel allows for direct suctioning or passage of a gastric tube.
        • Wide oval body prevents rotation and acts as an integral bite block.
        • Epiglottic blocking ridge reduces the possibility of epiglottic downfolding.

    • The Laryngeal Mask (LM) is a commonly used device in anesthesia as an alternative to a face mask or endotracheal tube.

    • Components include:

      • A wide internal diameter, transparent tube with a 15mm proximal end connection.
      • An ellipse-shaped cuff with a pilot balloon and self-sealing valve for inflation at the distal end.
      • Low-cost disposable LMs are widely used.
      • A modified design (LMAProSeal) has an additional lateral lumen for blind passage of an orogastric tube and improved seal pressure.
      • A single-use version, LMA Supreme, combines the best features of previous LMA versions and contains an ellipse cuff and anatomically shaped curve for easier insertion and a double seal for improved gas exchange.

    • LMs can be used for oropharyngeal sealing, reducing the risk of stoma insufflation during ventilation, and providing a passive conduit for unexpected regurgitation or active suctioning.

    • A well-placed LM can act as a conduit for oral intubation in difficult situations such as "can't intubate, can't ventilate."

    • LMs provide little or no protection against aspiration and should not be used in patients with full stomas or those prone to reflux.

    • The use of LMs is increasing in various settings including routine anesthesia, emergency airway management, and as an aid to intubation.

    • Extraglottic airways (LMAs) require the suppression of airway reflexes such as the gag reflex with general or topical anesthesia.

    • The use of LMs can lead to increased cardiac stability and improved blood oxygenation during surgery and anesthesia.

    • The application of negative pressure or intermittent positive pressure on the LM cuff can improve the seal and prevent air leaks.

    • The use of a bite block integrated with LMs can prevent damage to the teeth and improve patient comfort.

    • The use of a stylet can facilitate the insertion of a difficult LM and can reduce the risk of trauma to the vocal cords.

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    Description

    Test your knowledge on emergency airway management with this quiz. The quiz covers topics such as using devices for oral tracheal intubation, decision-making in difficult scenarios, and contraindications for certain airway devices.

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