Final FRCA Airway Study Day 7/10/20

1 comments on “Final FRCA Airway Study Day 7/10/20”

Comment posted by Emilie Martinoni Hoogenboom on 5th Oct 2020
Please see here these case-based discussions (not real patients). They will be discussed on Wednesday afternoon: 01 Dislodged ETT / Human Factors You are called urgently to the ITU, following an accidental extubation of a patient with a large goitre, who was previously a Grade 3 intubation. The ITU reg has attempted to re-intubate, but can only obtain a Grade 4 view. The airway is currently being maintained with a #4 –gel, with SpO2 of 96%. 1) Who would you want available at this stage? Discuss the management options for this patient. 2) You have transferred the patient to theatre and proceed to change the LMA for an ETT, using a fibreoptic scope & Aintree Exchange catheter through the LMA. 3) What roles would you allocate to your team members? 4) Unfortunately, the procedure is unsuccessful and the patient begins to further desaturate. Ventilation is now difficult. What are the next steps in your management? 5) Discuss the importance of human factors in the management of this situation. 02 RADIOTHERAPY AND ACUTE STRIDOR - INTUBATION 68 y/o Male with hypopharyngeal mass Recent treatment with chemo & radiotherapy Admitted to A&E with increasing stridor (for the past two weeks) Now: Resp rate 36, Sp02 83% in Air. 1) Discuss the initial management of this patient? How would you assess the airway of the patient? 2) Medical management has been unsuccessful and so you make preparations to secure the patient’s airway. Describe how you would induce anaesthesia and how you would secure the airway for this patient? 3)What would be the ongoing management for this patient? 03 Laryngeal Tumour / Extubation plan 1) What further information would you want to know about this patient? 2) What are your options for airway management for this patient? 3) What are the options available to maintain anaesthesia? 4) Discuss how you would manage the extubation of this patient. What are your post-operative concerns for this patient? 71-year-old patient Hx stidor Requires a microlaryngoscopy & biopsies 04 LASER 45 y/o with Laryngeal Cancer scheduled for laser resection surgery. 1) What are the oxygenation and airway options for patients undergoing laser airway surgery? 2) What are the possible complications of HFJV? 3) What will determine which airway option you choose for this patient? Following pre-operative assessment and discussion with the surgical team, you secure the airway with a laser safe ETT. 4) How will you minimise the risk of airway fire in this case? 5) Despite precautions, an airway fire occurs. How do you manage the situation?