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You are orally intubating a patient experiencing spasmodic closure of the vocal cords from laryngeal spasm. What is the best way to get the cords to allow the passage of the ET tube in this situation?

A. Applying a copious amount of lubrication on the tube and vocal cords

B. Apply steady cricoid pressure throughout the intubation

C. Allow the tip of the stylet to exit the end of the tube to serve as a guide through the narrow opening

D. A forceful upward pull of the jaw to reposition the airway

1 Answer

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Final answer:

The best way to manage a laryngeal spasm during intubation is to apply steady cricoid pressure, aiding the passage of the ET tube. This method is safer and less likely to cause trauma to the airway compared to using a stylet or forceful jaw manipulation.

Step-by-step explanation:

Managing Laryngeal Spasm During Intubation

Intubating a patient experiencing a laryngeal spasm can be challenging due to involuntary spasmodic closure of the vocal cords. The most appropriate action in this scenario would be to apply steady cricoid pressure throughout the intubation. This maneuver is known as the Sellick maneuver and can help to alleviate the spasm, thereby permitting the passage of the endotracheal (ET) tube. It is critical not to use a stylet extending beyond the tube or forceful manipulation as this can cause trauma to the airway structures. Instead, the application of cricoid pressure should be maintained in a steady fashion while gently inserting the lubricated ET tube.

Other intubation techniques may include the use of muscle relaxants or anesthetics administered intravenously by a qualified professional to alleviate the spasm. However, these should only be conducted under expert supervision, and the most immediate non-pharmacological approach remains steady cricoid pressure.

Proper endotracheal intubation technique is crucial for maintaining an open airway and ensuring patient safety during medical procedures, particularly in emergency situations where laryngeal spasm poses a risk to the patient's ability to breathe effectively.

User Ken Sharp
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