Advanced Airway Flashcard
Rationale
B. Rationale: The laryngeal mask can be placed blindly over the glottis. The mask is then slightly inflated as recommended by the manufacturer’s instructions. It is then advanced inferiorly until resistance is felt, which signifies the mask is positioned over the glottis. It is then inflated to form a tight seal around the pharynx so that no air escapes after each ventilation.
Question
What is the procedure for inserting a laryngeal mask?
a. Use a laryngoscope to push aside soft structures, visualize the vocal cords, and then insert the laryngeal mask through them.
b. Slightly inflate the laryngeal mask, and advance the tube until there is resistance felt at the level of the hard palate.
c. Perform an emergency cricothyrotomy, and insert the laryngeal mask through the temporary hole in the thyroid cartilage.
d. Clamp the laryngeal mask with one hand over the nose and mouth using the E-C technique, and then squeeze the self-inflating bag with the opposite hand to deliver each breath.
Answer
b. Slightly inflate the laryngeal mask, and advance the tube until there is resistance felt at the level of the hard palate.
Rationale
D. Rationale: In order to perform endotracheal intubation, a laryngoscope is necessary. It is a lighted instrument used to push aside the anatomical obstructions that hinder visualization of the epiglottis and vocal cords to facilitate the insertion of an ET tube.
Question
When inserting an endotracheal tube for advanced airway placement, which one of the following devices is necessary?
a. Intravenous catheter
b. Nasal cannula
c. Bronchoscope
d. Laryngoscope
Answer
d. Laryngoscope
Rationale
A. Rationale: The nasal-tragus length method can be used in term and preterm newborns. It is based on measuring the distance between the baby’s nasal septum and the tragus of the ear plus 1 centimeter. For example, a baby has a nasal tragus length of 5 cm, then adding 1 cm makes a total intubation depth of 6 cm. Use the markings on the tube and find the 6 cm demarcation. It should be inserted so that demarcation right by the baby’s lips.
Question
Which method can estimate the endotracheal tube insertion depth?
a. The nasal-tragus length method
b. The abdominal circumference method
c. The biparietal diameter method
d. All of the above
Answer
a. The nasal-tragus length method
Rationale
B. Rationale: The following are advanced airways: endotracheal tube, laryngeal masks, and esophageal-tracheal airways. Laryngeal mask airways are not currently made in sizes small enough for preterm infants.
Question
Which of the following is not an advanced airway option for a preterm infant?
a. Endotracheal tube
b. Laryngeal mask airway
c. Esophageal-tracheal airway
d. OG tube
Answer
b. Laryngeal mask airway
Rationale
A. Rationale: To date, no manufacturer has developed a laryngeal mask for neonatal resuscitation for preterm infants. An endotracheal tube is used because it has sizes that can fit the preterm population.
Question
Which one of the following advanced airways or techniques can be used for a preterm newborn in need of neonatal resuscitation?
a. Endotracheal tube
b. Laryngeal mask
c. Nasal cannula
d. Continuous positive airway pressure
Answer
a. Endotracheal tube
Rationale
C. Rationale: There are two alternative airways methods used for delivering PPV: endotracheal intubation and laryngeal mask airway insertion. ET tubes are made of a polyvinyl chloride material with a diameter designed to fit inside the glottis. The laryngeal mask is inserted against the hard palate until the healthcare provider feels resistance.
Question
Which one of the following medical devices is an advanced airway used for neonatal resuscitation?
a. Oropharyngeal airway
b. Nasopharyngeal airway
c. Laryngeal mask airway
d. T-piece resuscitator
Answer
c. Laryngeal mask airway
Rationale
D. Rationale: The laryngoscope is a device that uses a blade for moving aside the tongue and hypopharynx to visualize the vocal cords between which the endotracheal tube should be inserted.
Question
You are preparing the instruments for an upcoming high-risk birth. Which one of the following instruments is necessary to give a clear view of the newly born’s airway if an endotracheal tube must be inserted?
a. A stethoscope
b. An otoscope
c. An ophthalmoscope
d. A laryngoscope
Answer
d. A laryngoscope