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