Description

1. Regarding airway compromise, which of the following is NOT a sign/symptom of this emergency? A. Change in voice tone. B. Stridor. C. Decreased pulse pre ssure. D. Dyspnea and agitation. E. Tachypnea. The correct answer is: Decreased pulse pressure. OBJECTIVE SIGNS OF AIRWAY OBSTRUCTION Patients with objective signs of airway difficulty or limited physiological reserve must be managed with extreme care. This applies, among others, to obese patients, pediatric patients, older adults, and patients who have sustained facial trauma. The following steps can assist clinicians in identifying objective signs of airway obstruction: Observe the patient to determine whether he or she is agitated (suggesting hypoxia) or obtunded (suggesting hypercarbia). Cyanosis indicates hypoxemia from inadequate oxygenation and is identified by inspecting the nail beds and circumoral skin. However, cyanosis is a late finding of hypoxia, and it may be difficult to detect in pigmented skin. Look for retractions and the use of accessory muscles of ventilation (tachypnea) that, when present, offer additional evidence of airway compromise. Pulse oximetry used early inthe airway assessment can detect inadequate oxygenation before cyanosis develops. Listen for abnormal sounds. Noisy breathing is obstructed breathing. Snoring, gurgling, and crowing sounds (stridor) can be associated with partial occlusion of the pharynx or larynx. Hoarseness (dysphonia or change in tone) implies functional laryngeal obstruction. Evaluate the patient´s behavior. Abusive and belligerent patients may in fact be hypoxic; do not assume intoxication.