1. At what Glascow scale should a patient be intubated?
  2. How can we secure the airway in a patient with a cervical spine injury?
    • Secure airway first, then deal with the cervical spine injury!
    • The best answer is the use of a flexible bronchoscope but orotracheal intubation can still be performed with manual cervical immobilization.
  3. If a pt has breathed smoke, how can we secure their airway?
    For pts with smoke inhalation, you may have to intubate them to secure their airway.
  4. What diagnostic imaging is used for smoke inhhalation?
  5. If "crepitus" or "subcutaneous emphysema" is found on palpation of the neck, what is the best next step in management?
    Use a flexible bronchoscope (via nasal intubation). 

    The presence of subcutaneous emphysema indicates THORACIC TRAUMA which is a major traumatic disruption of the tracheobronchial tree.
  6. In which pt should you NOT do a SURGICAL cricothyroidotomy?
    For pts <12 years, instead perform a NEEDLE cricothyroidotomy  to avoid having to perform laryngeal reconstruction in the future.
  7. What is surgical cricothyroidotomy?
    The cricothyroid membrane is incised and an endotracheal or tracheostomy tube is placed into the trachea.
  8. Pt presents with respiratory distress, absent breath sounds, tracheal deviation and hyperresonance to percussion. What is the best next step in management?
    1. First, place a LARGE-BORE NEEDLE (needle thoracostomy) or IV CATHETER into the pleural space at the 2nd intercostal space midclavicular line

    2. Then place a CHEST TUBE (tube thoracostomy) in the anterior midaxillary line in 4th intercostal space (level of nipple in men).

    please do not ever wait for CXR or ABG!
  9. Pt presents with hypotension, shortness of breath and jugular vein distension. What is the best next step in management?
    First perform pericardiocentesis. If unsuccessful, then proceed with pericardial window placement.
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