Exam (elaborations)
FISDAP AIRWAY EXAM MID EAST WITH COMPLETE SOLUTION
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FISDAP AIRWAY EXAM MID EAST WITH COMPLETE SOLUTION
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FISDAPAIRWAY
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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