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Chapter 21. Airway Management with Blunt Anterior Neck Trauma

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A patient presents with stridor and an oxygen saturation of 85%. What is the ventilation device of choice to attempt to provide oxygenation after passive means have failed?

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A. Laryngeal Mask Airway

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B. Intubating Laryngeal Mask Airway

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C. Bag-valve-mask device

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D. King LT™ Airway

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E. Combitube™

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(C) A bag-mask-ventilation is the ventilation device of choice to attempt to enhance oxygenation in a patient who presents with stridor and an oxygen desaturation following a blunt anterior neck trauma. The use of EGDs may be contraindicated in the setting of supraglottic or glottic disruption, or distortion.

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What method of oxygenation can be used during bronchoscopic intubation in an attempt to maintain oxygen saturation?

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A. Bilevel positive airway pressure

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B. Non-rebreather mask

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C. Nasal cannula

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D. High-flow nasal oxygen

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E. Venturi mask

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(D) The amount of time the practitioner has to perform bronchoscopy and intubation will depend on the ability to maintain oxygen saturation. High-flow nasal oxygen during the bronchoscopic attempt might assist to provide prolonged maintenance of oxygenation.

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What are the limitations of percutaneous cricothyrotomy in the setting of blunt anterior neck trauma with a concomitant laryngeal fracture?

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A. Subcutaneous air may mimic intratracheal air, providing false localization.

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B. Airway distortion may not allow readily identifiable, percutaneous airway structures.

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C. Distal tracheal disruption may not be identified.

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D. Advancement of the guidewire through the needle may be difficult.

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E. All of the above.

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(E) All of the statements are potential limitations of percutaneous cricothyrotomy in the setting of blunt anterior neck trauma with a concomitant laryngeal fracture.

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