CASE STUDY: ACUTE AIRWAY MANAGEMENT

While dining at a local restaurant, your attention is drawn to a male in his forties, clutching his neck and apparently struggling to breathe. Within a short period of time, he collapses to the ground. As you make your way over to the individual, you can see he has become profoundly cyanotic and his sternocleidomastoid muscles are bulging each time he attempts a breath. Suddenly his labored breathing efforts begin to slow and you initiate standard CPR/obstructed airway protocol. After several minutes of intervention, you are unsuccessful and you are told his pulse has slowed and is non-palpable.

Study Questions

1. Acute airway obstruction may cause:

1. a decrease in LOC
2. a decrease in heart rate (bradycardia)
3. cyanosis
4. use of accessory muscles of respiration (intercostal, substernal, sternocleidomastoid, diaphragm)

1. (1, 2 only)
2. (2, 3 only)
3. (3, 4 only)
4. (all of the above)

2. Clinical cyanosis demonstrates:

1. the presence of at least 5gm of reduced hemoglobin
2. an arterial pa02 of less than 60mmHg
3. renal failure
4. high levels of lactic acid

3. If an individual becomes unconscious due to an acute, total airway obstruction:

1. their survival depends on getting adequate doses of epinephrine
2. the only chance for survival is early defibrillation
3. atropine is indicated to speed up the heart rate
4. timely restoration of a patent airway is the only chance for a good outcome

4. If standardized basic life support (BLS) obstructed airway interventions fail to open the airway, and they patient cannot be ventilated:

1. chest compressions can be useful up to 30 minutes to prevent death
2. the patient should be pronounced dead
3. an emergency surgical airway needs to be established (cricothyroidotomy)
4. emergency chest decompression must be performed