FISDAP AIRWAY EXAM MID EAST
Significance of stomach distension, and rapidly decreased ETCO2 after successful
intubation - correct answer-Tube was placed into oesophagus
Method to RAPIDLY confirm that a stoma is clear (direct laryngoscopy, suction, removing
inner
cannula) * - correct answer-remove inner catheter to see that its clear
Methods to clear tracheostomy tubes - correct answer-3 ml of saline and suction.
"Maximum allowable time" for intubation attempts. - correct answer-30 seconds with
oxygenation between attempts
Indications and contraindications for nasotracheal intubation - correct answer-Indications:
Breathing spontaneously but require definitive airway management. Responsive
patients and patients with an altered mental status and an intact gag reflex who are in
respiratory
failure.
Contraindications: patients that should receive orotracheal intubation, head trauma, and
possible midface fractures.
Differential diagnosis for emphysema, pneumonia, pleural effusion and CHF - correct
answer--Emphysema (Pink Puffer "Polycythemia", Barrel chested) is a loss of elasticity of the
alveoli of the lungs. This causes extra dead space and these patients breathe off of a
hypoxic drive due to the retained CO2 in the lungs and respiratory system.
-Pneumonia is going to incorporate a FEVER. Most commonly it is only a one sided issue.
Productive cough. Ask about secretion color.
- Pleural effusion is air or fluid in the chest cavity "air or fluid constricts lung, making it harder
to breathe" (Visceral Pleura, Parietal Pleura Space). Sharp pain made worse by deep breath.
-CHF is going to have pedal edema and cough up pink frothy sputum. Exacerbated by lying
flat (Orthopnea). Known by history and medications taken. left sided heart failure precedes
right side heart failure. Pump problem not a pipe problem.
Treatment of asthma patients depending on how they present (wheezes or not, mannerism
of
speaking, distress etc) - correct answer-Patients who are hypersensitive- remove them from
irritant
Asthma patient who is dehydrated- needs hydrated
, Asthma patients who are wheezing- Nebulizer treatment, also consider corticosteroid and
CPAP
Blue Bloater (Chronic Bronchitis) - correct answer-Chronic Bronchitis: airway flow problem,
recurrent productive cough, hypoxia, respiratory
acidosis, dyspnea on exertion, high hemoglobin, 'blue bloater' increase respiratory rate,
dyspnea on
exertion, digital clubbing, fat finger tips, cardiac enlargement, bilateral lower extremity
enlargement
pink puffer - correct answer-Emphysema: Pursed lip breathing, barrel chested, high RR (to
compensate for poor functioning
lungs), high HR, 'pink puffers', pink skin caused by polycythemia which is overproduction of
red blood
cells
Escalation of airway management in a burn patient. - correct answer-Be prepared to
intubate. Basic airway management, nebulizer treatment. Be ready to intubate.
NTG=(Nitro) - correct answer-vasodilator that works throughout the entire body. Decreased
the work of the
heart. Gives somewhere for the fluid to go. Give SL 0.4 mg q 3-5 min. Given also as 1"
nitropaste
Drip dose. Nitro Drip 10 mcg/min.
Lasix(furosemide) - correct answer-40-100 mg IV/IO. (0.5-1 mg/kg). Indications=Pulmonary
Edema/CHF. Double
dose of prescribed dose. DO NOT GIVE IF PATIENT IS HYPOTENSIVE OR
HYPOVOLEMIC. Works in
the Loop of Henle in the kidneys. Moves Sodium, and also causes shift in potassium.
Albuterol - correct answer-2.5 mg nebulized. Works on B2 receptors. Bronchodilator.
Contraindications=CHF.
Use caution with tachydysrhythmias.
Dexamethasone - correct answer-Dexamethasone=Corticosteroid. 10-100 mg IV Push 1
mg/kg IV bolus. Pedi 0.25-1 mg/kg IV.IO.
IM. You can have the pt drink the medication if no IV. Contraindication-Systemic Sepsis.
Epinephrine - correct answer-Epinephrine= 0.3-0.5 mg of 1:1,000 IM ONLY!!! NO IV. No
selective agent Alpha and Beta
Sympathomimetic, Vasopressor, Bronchodilator. Contraindications=Hypersensitive,
hypovolemic shock, hypertension, Narrow Angle Glaucoma.Epinephrine=
Ipatroprium Bromide=(Atrovent). - correct answer-0.5 mg Nebulized. Anticholinergic. Acts by
inhibiting the
interactions of ACH at the receptors (Beta-2) resulting in smooth muscle relaxation and
Bronchodilation.
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