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Chapter 10. Flexible Bronchoscopic Intubation

Complications associated with bronchoscopic intubation include

A. laryngospasm

B. complete airway obstruction

C. local anesthesia toxicity

D. laryngeal trauma

E. all of the above

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

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?

A. immersed in a solution of peracetic acid

B. disinfection of bronchoscopes using orthophthaldehyde (Cidex)

C. disinfection of bronchoscopes using ethylene oxide

D. disinfection of bronchoscopes using an autoclave

E. none of the above

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

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

A. profound regional anesthesia of the airway

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

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

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

E. all of the above

(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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