SAQ 2016 – Child with burns and failed airway attempts after a barbecue explosion

You are the consultant in charge of the paediatric section of a rural ED. A 5-year-old boy arrives by ambulance 30 minutes after a home barbecue gas bottle exploded indoors.

He has soot on his face with severe swelling of the cheeks, lips and eyelids. Observations are SpO2 89% on 15 L/min oxygen by non-rebreather mask, pulse 120/min, capillary refill 3 seconds and RR 28/min.

You perform RSI for airway protection but cannot visualise the cords with video laryngoscopy, and cannot ventilate with a bag-mask or laryngeal mask. The on-call anaesthetist is more than 10 minutes away.

State your immediate management.

(Marked out of 5.0)

/ 5

List three causes of impaired oxygenation in this patient and the cause of each.

(Marked out of 3.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Impaired oxygenation problem</th> <th>Cause</th> </tr> </thead> <tbody> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> </tbody> </table> <p>

/ 3

After successful intubation, list ventilator settings with justification.

(Marked out of 4.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Setting</th> <th>Justification</th> </tr> </thead> <tbody> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> </tbody> </table> <p>

/ 4

Total Score: 0 / 12

Percentage: 0%