DAANCE- Module 5- Office Anesthesia
Emergencies Exam 100% Complete.
Mallampti Classification - Answer Visual analysis of the oral/oropharyngeal anatomy
Mallampti Class I - Answer Visualization of the soft palate, fauces, uvula, anterior
and posterior pillars
Mallampti Class II - Answer Visualization of the soft palate, fauces, and uvula
Mallampti Class III - Answer Visualization of the soft palate and the base of the uvula
Mallampti Class IV - Answer Soft palate is not visible at all.
Signs of Airway Obstruction - Answer Choking, gagging, substernal notch retraction,
labored breathing, rapid pulse initially, then decreased pulse, respiratory arrest, and
cardiac arrest
Treatment of Airway Obstruction - Answer Early Treatment: 100% O2 via nasal
mask, trendelenburg position (pack of surgical site), digital traction of tongue (with
gauze, tongue forceps, hemostat, or sutures), suctioning of the oropharynx.
Advanced Treatment: Abdominal thrusts, laryngoscopy, cricothrotomy.
Larygospasm- what is it, and what can a partial or complete closure result in? -
Answer Protective reflex of the vocal cords that attempts to stop foreign matter
getting into the larynx, trachea, and lungs. Partial or complete closure of the vocal
cords can occur resulting in airway obstruction.
Treatment of Laryngospasm - Answer 100% O2 via nasal hood, maintain/establish
airway, pack off surgical site, suction of oral cavity and oropharynx, positive
pressure, 100% oxygen via bag/mask system, succinylcholine
(Deepening the level of anesthesia may also help)
Bronchospasm - Answer Generalized contraction of the smooth muscles of the small
bronchi and bronchioles of the lungs, resulting in restriction of airflow to and from the
lungs. Patient will have more difficulty with expiration than inspiration.
Patients more susceptible to bronchospasm - Answer Patients with history of
allergies, asthma, COPD, and bronchitis
Diagnosis of Bronchospasm - Answer Labored breathing, aspirational difficulty, signs
of diminishing respiratory status (cyanosis or decreased ventilation patterns on
capnograph)
Treatment of Bronchospasm - Answer 100% Oxygen via bag/mask, albuterol,
atrovent, epinephrine injection, intubation/ventilation, steroid injection,
diphenhydramine, aminophylline. (Activate EMS after steroid injection if it has not
been resolved)
, DAANCE- Module 5- Office Anesthesia
Emergencies Exam 100% Complete.
Aspiration - Answer Occurs when the contents of the stomach enter the lungs
secondary to emesis, or when a foreign body or fluid inadvertently enters the lungs
from the oral pharyngeal cavity through the larynx.
Treatment of Emesis with Aspiration - Answer Activate EMS, 100% O2 via
bag/mask, turn patient on right side with head down (trendelenburg position), tonsil
suction, removal of visible foreign bodies, intubation, transport to acute care facility
Hyperventilation - Answer Occurs when the patient is breathing at a rate faster than
his/her normal breathing pattern or breathing more deeply than the body requires.
Triggered by a change in body's natural balance of oxygen and carbon dioxide.
Patient exhales too much carbon dioxide and will begin to feel light headed.
Treatment of Hyperventilation - Answer Early: terminate treatment and remove
foreign bodies from mouth and remove surgical instruments from view, maintain
airway, verbally try to calm the patient, monitor vitals, DO NOT GIVE OXYGEN, have
patient breathe into a bag to recapture exhaled CO2
Advanced: If patient is not sedated try IV midazolam, diazepam, propofol, etc.,
continue to monitor vitals, discontinue breathing bag as breathing returns to normal,
activate EMS if condition deteriorates
Respiratory Depression and Apnea - Answer Can be the result of many different
causes and can result in increased heart rate and the development of hypoxia and
cyanosis. Many of the drugs administered for sedation can depress or stop the
patient's ability to breathe
Acute Coronary Syndrome - Answer Two components:
1. Angina: damage to myocardium from dimished blood flow through coronary
arteries.
2. Myocardial infarction: death of myocardial tissue when coronary arteries become
occlueded.
Treatment of Angina Attack- what are the steps, and what can we assume after a
certain amount of treatment? - Answer Stop surgery, give Nitroglycerine and 100%
oxygen, make patient comfortable. If 3 doses of nitroglycerin does not provide relief,
it should be assumed the patient is having a myocardial infarction
Treatment of Miocardial infarction - Answer Stop surgery, remove foreign bodies
from mouth, place in comfy position, oxygen, activate EMS when surgeon tells you
too
Treatment of Acute Coronary Syndrome - Answer Activate EMS and closely observe
vitals, 100% O2 via mask, make patient comfy/reassure, attach AED defibrillator,
Aspirin 325 mg, establish IV access with normal saline slow drip, morphine for pain
MONA - Answer Morphine (helps with pain, decreases BP, and workload of heart)
Oxygen (heart needs oxygen)
Nitroglycerin (dilates blood vessels)
Emergencies Exam 100% Complete.
Mallampti Classification - Answer Visual analysis of the oral/oropharyngeal anatomy
Mallampti Class I - Answer Visualization of the soft palate, fauces, uvula, anterior
and posterior pillars
Mallampti Class II - Answer Visualization of the soft palate, fauces, and uvula
Mallampti Class III - Answer Visualization of the soft palate and the base of the uvula
Mallampti Class IV - Answer Soft palate is not visible at all.
Signs of Airway Obstruction - Answer Choking, gagging, substernal notch retraction,
labored breathing, rapid pulse initially, then decreased pulse, respiratory arrest, and
cardiac arrest
Treatment of Airway Obstruction - Answer Early Treatment: 100% O2 via nasal
mask, trendelenburg position (pack of surgical site), digital traction of tongue (with
gauze, tongue forceps, hemostat, or sutures), suctioning of the oropharynx.
Advanced Treatment: Abdominal thrusts, laryngoscopy, cricothrotomy.
Larygospasm- what is it, and what can a partial or complete closure result in? -
Answer Protective reflex of the vocal cords that attempts to stop foreign matter
getting into the larynx, trachea, and lungs. Partial or complete closure of the vocal
cords can occur resulting in airway obstruction.
Treatment of Laryngospasm - Answer 100% O2 via nasal hood, maintain/establish
airway, pack off surgical site, suction of oral cavity and oropharynx, positive
pressure, 100% oxygen via bag/mask system, succinylcholine
(Deepening the level of anesthesia may also help)
Bronchospasm - Answer Generalized contraction of the smooth muscles of the small
bronchi and bronchioles of the lungs, resulting in restriction of airflow to and from the
lungs. Patient will have more difficulty with expiration than inspiration.
Patients more susceptible to bronchospasm - Answer Patients with history of
allergies, asthma, COPD, and bronchitis
Diagnosis of Bronchospasm - Answer Labored breathing, aspirational difficulty, signs
of diminishing respiratory status (cyanosis or decreased ventilation patterns on
capnograph)
Treatment of Bronchospasm - Answer 100% Oxygen via bag/mask, albuterol,
atrovent, epinephrine injection, intubation/ventilation, steroid injection,
diphenhydramine, aminophylline. (Activate EMS after steroid injection if it has not
been resolved)
, DAANCE- Module 5- Office Anesthesia
Emergencies Exam 100% Complete.
Aspiration - Answer Occurs when the contents of the stomach enter the lungs
secondary to emesis, or when a foreign body or fluid inadvertently enters the lungs
from the oral pharyngeal cavity through the larynx.
Treatment of Emesis with Aspiration - Answer Activate EMS, 100% O2 via
bag/mask, turn patient on right side with head down (trendelenburg position), tonsil
suction, removal of visible foreign bodies, intubation, transport to acute care facility
Hyperventilation - Answer Occurs when the patient is breathing at a rate faster than
his/her normal breathing pattern or breathing more deeply than the body requires.
Triggered by a change in body's natural balance of oxygen and carbon dioxide.
Patient exhales too much carbon dioxide and will begin to feel light headed.
Treatment of Hyperventilation - Answer Early: terminate treatment and remove
foreign bodies from mouth and remove surgical instruments from view, maintain
airway, verbally try to calm the patient, monitor vitals, DO NOT GIVE OXYGEN, have
patient breathe into a bag to recapture exhaled CO2
Advanced: If patient is not sedated try IV midazolam, diazepam, propofol, etc.,
continue to monitor vitals, discontinue breathing bag as breathing returns to normal,
activate EMS if condition deteriorates
Respiratory Depression and Apnea - Answer Can be the result of many different
causes and can result in increased heart rate and the development of hypoxia and
cyanosis. Many of the drugs administered for sedation can depress or stop the
patient's ability to breathe
Acute Coronary Syndrome - Answer Two components:
1. Angina: damage to myocardium from dimished blood flow through coronary
arteries.
2. Myocardial infarction: death of myocardial tissue when coronary arteries become
occlueded.
Treatment of Angina Attack- what are the steps, and what can we assume after a
certain amount of treatment? - Answer Stop surgery, give Nitroglycerine and 100%
oxygen, make patient comfortable. If 3 doses of nitroglycerin does not provide relief,
it should be assumed the patient is having a myocardial infarction
Treatment of Miocardial infarction - Answer Stop surgery, remove foreign bodies
from mouth, place in comfy position, oxygen, activate EMS when surgeon tells you
too
Treatment of Acute Coronary Syndrome - Answer Activate EMS and closely observe
vitals, 100% O2 via mask, make patient comfy/reassure, attach AED defibrillator,
Aspirin 325 mg, establish IV access with normal saline slow drip, morphine for pain
MONA - Answer Morphine (helps with pain, decreases BP, and workload of heart)
Oxygen (heart needs oxygen)
Nitroglycerin (dilates blood vessels)
