Image Based Question-66677

A unconscious patient due to trauma was brought to the hospital.For the purpose of assisted respiration,the following tube was needed(as shown in the image).

For the insertion of this tube,what would be the ideal positioning of the patient?

A. Flexion at the Atlanto-Occipital and extension at the Cervicothoracic junction.

B. Extension at Atlanto-Occipital and Flexion at Cervico-thoracic junction.

C. Flexion at the Atlantoccipital and Cervicothoracic junction

D. Extension at Atlanto-Occipital and Cervicothoracic junction

Show Answer

Correct Answer » B Explanation

Ans: B. Extension at Atlanto-Occipital and Flexion at cervicothoracic junction.

The image shows Endotracheal Tube

Endotracheal Intubation

• It describes the technique of passing a tube through the vocal cords.

Indications:

• Severe hypoxemia requiring PEEP; hypercapnia with acidosis; inability to protect the airway; to control ventilation in the presence of raised intracranial (or intraocular) pressure; to facilitate certain diagnostic or therapeutic procedures; to allow administration of neuromuscular blockade.

Procedure:

• The correct position is with the lower part of the cervical spine flexed (by placing a pillow or other suitable pad under the patient’s occiput), and the atlanto-occipital joint extended(by tilting the head back) – the so-called “sniffing position”. This position aligns the axes of the mouth, pharynx, and trachea, and will give the best visualization of the cords during laryngoscopy.

• The vocal cords are then visualized with the aid of a laryngoscope, cricoid pressure by a trained assistant is applied and the endotracheal tube visualized passing through them.

• The position of the tube in the trachea can be confirmed in a number of ways, including observing increasing end-tidal carbon dioxide, aspiration, chest movement and misting of the tube.

• A cuff is then usually inflated to provide a seal allowing positive pressure ventilation and to protect the airway from the aspiration of gastric contents or upper airway material.