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Airway Management

You are called to assist with the emergency care of a 45 year-old gentleman who underwent an urgent surgical tracheostomy two days previously for airway obstruction due to laryngeal cancer. The tracheostomy was performed because of a failed intubation performed by an experienced anaesthetist. On your arrival, the patient had a respiratory rate of 35 breaths per minute, a see-saw respiratory pattern and SaO2 of 86% on FiO2 0.5. Which is/are the best management option/s?:
a) Deflate the cuff of the tracheostomy and reposition the tracheostomy tube: TRUE/FALSE.
b) Provide oxygen via facemask and via tracheostomy tube: TRUE/FALSE.
c) Assess tracheostomy patency removing the inner tube: TRUE/FALSE.
d) Remove the tracheostomy tube and re – intubate in a standard fashion: TRUE/FALSE.

ALS new myocardial infarction definition

The term acute myocardial infarction should be used when there is acute myocardial injury with clinical evidence of acute myocardial ischaemia and with detection of a rise and/or fall of cTn (Troponin) values with at least one value above the 99th percentile URL and any of the following:

    a)  New ischaemic ECG changes: TRUE / FALSE.
    b) Development of pathological Q waves: TRUE / FALSE.
    c) Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality: TRUE / FALSE.
    d) Identification of a coronary thrombus: TRUE / FALSE.

European Heart Journal, ehy462, https://doi.org/10.1093/eurheartj/ehy462

ALS death

In the diagnosis of death:

A) After a cardiorespiratory arrest, death can be diagnosed without attempting to auscultate heart sounds: TRUE / FALSE.

B) Irreversible cardiorespiratory arrest can be concluded after a minimum of 5 minutes of observation: TRUE / FALSE.

C) CPR should never be started in recognition of life extinct (ROLE) situations: TRUE / FALSE.

D) Brainstem death testing should be performed with core temperature greater than 34ºC and potassium > 3 mmol/l: TRUE / FALSE.