answers
Terms in this set (197) ||\\//|| ||\\//|| ||\\//|| ||\\//||
Original
What are the predictors of difficult face mask ventilation?
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as per RcOA analysis are:
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Age > 55 ||\\//|| ||\\//||
BMI > 26 ||\\//|| ||\\//||
Edentulus
Facial hair ||\\//||
Hx of snoring
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Limited jaw protrusion ||\\//|| ||\\//||
Mallampati 3 - 4 ||\\//|| ||\\//|| ||\\//||
Previous notes / history of difficult airway ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
What can you do to improve face mask ventilation?
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Keep dentures in ||\\//|| ||\\//||
Shave beard ||\\//||
Use tegaderm on beard
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Airway adjuncts ||\\//||
SGA as an alternative to BMV post induction prior to intubation
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What are the predictors of difficult LMA placement?
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RODS
MO < 2.5cm ||\\//|| ||\\//||
Abnormal anatomy - won't sit well ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Laryngeal obstruction ||\\//||
Stiff lungs ||\\//||
Stiff neck ||\\//||
What are the predictors of difficult ETT placement?
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The strongest independent predictors of difficult intubation
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,Mallampati
Thyromental distance ||\\//||
(note sensitivity only 36%!) ||\\//|| ||\\//|| ||\\//||
TMD < 6 0 suggests intubation using conventional laryngoscopy may be difficult
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Upper lip bite test (mandible jaw protrusion) ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
JP = C -> diagnostic of difficult intubation
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Other tests include ||\\//|| ||\\//||
Inter-incisor distance ||\\//||
> 5cm = easy insertion of laryngoscope, but does not predict intubation difficulty
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relatively high predictive value ||\\//|| ||\\//|| ||\\//||
In morbid obesity what are the predictors of difficult intubation?
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Airway assessment ||\\//||
Neck circumference ||\\//||
Pre-tracheal soft tissue >2.5cm predictor of difficult airway ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
What equipment might we commonly place down an LMA?
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Cook AEC, Aintree catheter ||\\//|| ||\\//|| ||\\//||
Predictors of difficult FONA ||\\//|| ||\\//|| ||\\//||
Flexed neck / prominent thoracic kyphosis ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
AS
Neck stuff: ||\\//||
FAT
Tumour
Radiation
Blood
Surgery
Infection
beard
Describe an Aintree catheter ||\\//|| ||\\//|| ||\\//||
,56 cm long ||\\//|| ||\\//||
19Fr
6.5mm external diameter ||\\//|| ||\\//||
hollow and stiff enough to facilitate railroading of ETT ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
>= 7 ||\\//||
4.7 inner diameter ||\\//|| ||\\//||
Easily preloaded over ≤ 4.2 mm diameter fibrescope ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Comes with 2 rapifit adaptors - allows oxygen administration but be cautious of
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barotrauma/perforation
Max. depth 26cm ||\\//|| ||\\//||
Max O2 flow rate = 2L/min ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
(Louise airway notes) ||\\//|| ||\\//||
Describe the process of using an Aintree to intubate through an LMA ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
How to use to intubate through an LMA (EXCEPT THE SUPREME LMA)
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2 person technique
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prepare fibrescope and camera system ||\\//|| ||\\//|| ||\\//|| ||\\//||
lubricate outer surfaces of both AIC and fibrescope (FS) ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Preload AIC onto FS and secure with tape ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Attach a Bodie-Y connector (aka a 15mm bronchoscopic swivel connector (with port)) to the
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LMA and anaesthetic circuit ||\\//|| ||\\//|| ||\\//||
this enables ventilation while you are using the FS
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Confirm adequate anaesthesia, mm relaxation and assisted ventilation ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Get assistant to hold LMA still
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Introduce FS loaded with AIC thoguth the top port of the Bodie-Y connector ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Advance until you are ~ 3cm above the carina ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Note depth of AIC (MAXIMUM DEPTH 26cm) ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Remove tape attaching AIC to FS ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Withdraw FS while keeping AIC in situ at the same depth ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Withdraw LMA while keeping AIC in situ at same depth ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Railroad ETT (conventional size for F or M size 7 - 8) over AIC ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
, Use laryngoscope to ensure position of ETT ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Remove AIC and reconnect circuit -> confirm ventilation + anaesthesia ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Consider FS to confirm ETT position ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
https://www.youtube.com/watch?v=Pn8CRYZz4Q4
Describe the Cook Airway Exchange Catheter (AEC). Describe the process of using the Cook ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
AEC
Compare and contrast a Cook AEC and Aintree? ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Both are: long hollow tubes, able to ventilate, both have maximum depth of 26cm and max
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O2 flow rate of 2L/min, both have risk of barotrauma and perforation.
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Difference: Cook AEC - various sizes, long 100cm soft tip or shorter 83cm; Aintree can thread ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
a bronchoscope through and bronchoscopically guide
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What equipment do we commonly place down an ETT? ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
EQUIPMENT THROUGH ETT ||\\//|| ||\\//||
· Bronchoscope:
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o 3.2 mm ||\\//|| ||\\//||
o 4 mm → Use for placing DLT & intubating via LMA
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o 5.2 mm → 7.5 ETT
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· Cook Frova Bougie (Blue):
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o 14 Fr (4.7 mm)
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o Compatible with ≥ 6 ETT
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o Not compatible with DLT (shearing end of bougie)
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· Cook exchange catheter (green/purple):
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o 11 Fr (3.7 mm) → Compatible 4 ETT or 35 Fr DLT
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o 14 Fr (4.7 mm) → Compatible 5 ETT or 39 Fr DLT
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· Aintree intubating catheter:
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o 19 Fr (6.3 mm) → Compatible 7 ETT
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o Internal diameter 4.7 → Compatible 4 mm scope
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