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Chapter 21. Airway Management with Blunt Anterior Neck Trauma

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?

A. Laryngeal Mask Airway

B. Intubating Laryngeal Mask Airway

C. Bag-valve-mask device

D. King LT™ Airway

E. Combitube™

(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.

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

A. Bilevel positive airway pressure

B. Non-rebreather mask

C. Nasal cannula

D. High-flow nasal oxygen

E. Venturi mask

(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.

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

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

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

C. Distal tracheal disruption may not be identified.

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

E. All of the above.

(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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