Acute Airway Management

5.1.1 Discuss stridor and its relation to the site of obstruction. Can it predict degree of obstruction?

5.1.2 The ER doc calls you to evaluate an adult patient for epiglottitis. What would you expect to find on PE/FFOL? What investigations would you order?

5.1.3 Does the above patient need a work-up? How will you manage this patient? The patient is stridorous, but stable for now. Discuss airway management options.

As you are writing up the consult, the patient acutely obstructs. Discuss specific steps that you will execute to achieve a surgical airway. 

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5.1.4 Review the etiology and treatment of angioedema. 

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5.1.5 What is Ludwig’s angina?

5.1.6 Discuss the role of PFT’s and flow volume loops in the management of upper airway obstruction.

5.1.7 Discuss options for the surgical management of tracheal stenosis. Discuss pros and cons of endoscopic versus open surgery and the role of mitomycin C.

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Yamamoto K, Kojima F, Tomiyama K, Nakamura T, Hayashino Y. Meta-analysis of therapeutic procedures for acquired subglottic stenosis in adults. Ann Thorac Surg. 2011 Jun;91(6):1747-53. PMID:21619972

5.1.8 Describe the role of helium in the treatment of airway obstruction.

5.1.9 You are paged stat to the OR. Upon induction, the anesthesiologist has lost the airway.

Sofferman RA, Johnson DL, Spencer RF. Lost airway during anesthesia induction: alternatives for management. Laryngoscope. 1997 Nov;107(11 Pt 1):1476-82. PMID:9369393

5.1.10 Discuss the indications for an emergent surgical airway.

5.1.11 Should a cricothyroidotomy be converted to a tracheostomy? Why? When?