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Chapter 10. Flexible Bronchoscopic Intubation

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Complications associated with bronchoscopic intubation include

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A. laryngospasm

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B. complete airway obstruction

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C. local anesthesia toxicity

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D. laryngeal trauma

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E. all of the above

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(E) Laryngospasm, complete airway obstruction, local anesthesia toxicity, laryngeal trauma are potential complications of awake flexible bronchoscopic intubation.

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Which of the following is a reliable method of removing prions from the flexible bronchoscope following its use in a patient with Creutzfeldt–Jakob disease?

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A. immersed in a solution of peracetic acid

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B. disinfection of bronchoscopes using orthophthaldehyde (Cidex)

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C. disinfection of bronchoscopes using ethylene oxide

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D. disinfection of bronchoscopes using an autoclave

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E. none of the above

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(E) Presently, there is no reliable method of removing prions from the flexible bronchoscope following its use in a patient with Creutzfeldt–Jakob disease.

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During bronchoscopic intubation, which of the following can facilitate advancement of the ensleeved endotracheal tube to advance into the trachea over the bronchoscopic bronchoscope?

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A. profound regional anesthesia of the airway

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B. rotation of the tube 90 degree counterclockwise may be necessary to orient the bevel posteriorly

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C. minimize the discrepancy between the outside diameter of the bronchoscope and the internal diameter of the endotracheal tube

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D. the use of the ILMA tube which has a soft hemispherical bevel and a leading edge in the midline

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E. all of the above

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(E) All of the listed steps can facilitate advancement of the ensleeved endotracheal tube to advance into the trachea over the flexible bronchoscope.

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