Airway 20

What is oral ETT placement used for?

Most general surgery, rapid sequence induction

If a patient is conscious for oral/nasal intubation, what should be given?

IV sedation, topical anesthesia, blocks: superior laryngeal and transylaryngeal local anesthetic

What are potential minor difficulties with intubation?

Head position, correct laryngoscope blade, ETT size

What should be done after intubation?

Auscultate chest, chest end-tidal CO2, consider gastric tube for decompression

What are common complications of intubation (general)?

Hoarseness, sore throat, cough

What are common nasal complicaitons of intubation?

bleeding, submucosal passage, avulsion of turbinate, bacteremia, sequelae of vasoconstrictors (dysryhthmias, hypertension), maxillary sinusitis

What are common oral complications of intubation?

Damage to teeth, lips, gums, tongue, TMJ dysfunction

What clinical conditions would make you suspect a difficult airway?

History of difficult airway, prior tracheostomy, scars, short muscular neck, obesity, micrognathia, maxillary overbite, high vaulted palate, limited neck/TMJ mobility, contenital anomalies, maxillofacial trauma, c-spine injury, ludwig's angina, abscess, hematoma, epiglottitis, rheumatoid arthritis, alkylosing spondylitits

What is the first question to consider with a patient with a difficult airway?

Whether they are likely or unlikely to aspirate

For patients who are likely to aspirate, what intubation options are appropriate?

Regional anesthesia, RSI w/ critcoid pressure (not recommended if significant difficulty intubating is expected), Awake intubation