Difficult Airway Management

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Question 1 of 5

1. Question
Which of the following is most likely to indicate potentially difficult bag-valve mask (BVM) ventilation?
- Well fitting dentures
- Mallampati class III or IV view of oropharynx
- Age greater than 55 years
- Anatomically (as opposed to pathologically) large lips
- Body mass index <25kg.m–2
Question 2 of 5

2. Question
Which of the following airway items is the most important to have in the resuscitation room?
- Surgical airway kit
- Laryngeal mask airway (LMA)
- Fibreoptic scope
- McCoy laryngoscope
- Gum elastic bougie
Question 3 of 5

3. Question
A 23-year-old has been involved in a car crash. He requires intubation for respiratory failure secondary to pulmonary contusions. Following one failed attempt at intubation, his saturations have dropped from 98% to 92%.

What is the most appropriate course of action?
- Insertion of an LMA and ventilation
- Attempt to re-oxygenate with BVM ventilation, prior to a second intubation attempt
- Creation of some form of surgical airway, for example, cricothyroidotomy
- Release of manual in-line stabilisation to allow better positioning prior to a second intubation attempt
- Attempt to re-oxygenate with BVM ventilation, while awaiting the return of spontaneous ventilation
Question 4 of 5

4. Question
A 67-year-old patient with community-acquired pneumonia presents with hypoxia resistant to oxygen via a non-rebreathing mask (saturations of 82%). Following induction of anaesthesia, her saturations can be maintained at 94% with BVM ventilation but repeated attempts at intubation and placement of an LMA have failed.

What is the most appropriate course of action?
- Maintain sedation and BVM ventilation while awaiting the arrival, in 20 minutes, of the consultant anaesthetist with fibre-optic scope who will attempt intubation
- Allow the patient to wake and resume spontaneous ventilation while awaiting the arrival, in 20 minutes, of the consultant anaesthetist with fibre-optic scope who will attempt intubation
- Secure the airway via a percutaneous tracheostomy as she is likely to require a prolonged course of ventilation
- Secure the airway via an open or Seldinger technique cricothyroidotomy
- Secure the airway via retrograde intubation
Question 5 of 5

5. Question
A morbidly obese 60-year-old man with a beard has been involved in a road traffic accident.

He has been complaining of significant neck pain and has developed severe hypoxia as a result of a flail chest with pulmonary contusions.

Following induction of anaesthesia, it is proving impossible to maintain saturations above 70% with BVM ventilation and three attempts at intubation have failed.

What is the most appropriate course of action?
- Release in-line stabilisation to optimise head positioning for laryngoscopy and intubation
- Shave his beard off to allow a better seal for BVM ventilation
- Allow him to wake and return to spontaneous ventilation
- Perform a percutaneous tracheostomy
- Perform an open or Seldinger cricothyroidotomy

Difficult Airway Management – Post Test

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