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MEQ

Anatomy of the airway


1. Draw the Airway anatomy you see on laryngoscope
2. Difference between infant and adult airway
Airway assessment
3. List down Mallampatis classes
4. List 5 causes of anatomical difficulties intubation
5. Draw Cormack & Lehane base on its grading
6. List 5 Management plan of anticipated difficult airway
7. List 5 alternatives equipment to anticipate difficult intubation
Primary Survey and Secondary survey
8. List down Primary survey accordingly
9. List down chest life threatening chest injury
10. Draw safety triangle, Define Open or Closed Thoracotomy
11. List 5 Indication of Chest tube
12. How do you suspect Tension Pneumothorax and its Immediate managements in Trauma, List 5
13. Definition of Massive Hemothorax and Flail Chest
14. Define Cardiac tamponade and Becks Triad
15. Define FAST literally and the probe locations accurately
CT brain and Cervical clearance
16. Draw types of brain hemorrhages location
17. List all the need for Head CT Scan (Canadian and New Orleans Criteria)
18. Cerebral Resuscitation
19. List all CT Cervical clearance (Nexus Criteria)
RSI and Indication for intubation
20. List at least 5 indications for intubations
21. Define RSI accurately and Step by Step approach for RSI
22. List 9 basic equipment needs for RSI
23. Inducting agent for RSI and List down each of it with the doses
24. Medications used for Neuromuscular blocker, List down and its doses
25. List 5 Proofs of the placement of ETT
Fluid management in trauma
26. Draw table with types of Hypovolaemic Shock
27. The advantages and Disadvantages of Crystalloid and Colloid
Basic Principle wound managements
28. Goals of Wound Care
29. How to manage amputated parts
Anatomy of the airway
1. Draw the Airway anatomy you see on laryngoscope
- Tongue, Vocal Cord, Epiglottis, Vestibular folds, Pyriform fossa, Trachea, Esophagus

2. Difference between infant and adult airway

Airway assessment
3. List down Mallampatis classes
- Class 1 : Complete visualization of soft palate
- Class 2 : Complete visualization of the uvula
- Class 3 : Visualization of only the base of uvula
- Class 4 : Soft palate is not visible at all
4. List 5 causes of anatomical difficulties intubation
- Obesity, Short or thick neck, Poor mobility of neck, Long or High arched palate, Macroglossia,
Protruding incisor teeth, Decrease in Atlanto-Occipital Distance
5. Draw Cormack & Lehane base on its grading

6. List 5 Management plan of anticipated difficult airway


- Discussion with colleague in advance
- Test equipment beforehand
- Senior help backup
- Backup plan if fail initial intubation (Eg, Surgical intervention, Bougie, etc)
- Inform Anaest/Surgery team to standby
7. List 5 alternatives equipment to anticipate difficult intubation
- Bougie
- LMA
- Fibre-Optic
- Combitube
- Stylette device (Flexible/Rigid/Etc)
- Cricodothyroidectomy equipments

Primary Survey and Secondary survey


8. List down Primary survey accordingly
- DR A+C, B, C, D, E
9. List down chest life threatening chest injury
- Airway disruption, Tension Pneumothorax, Open Pneumothorax, Massive Hemothorax, Flail
Chest, Cardiac Tamponade
10. Draw safety triangle, Define Open or Closed Thoracotomy

- Lateral edge of pectoralis major, Anterior edge of latissimus dorsi (Mid-Axillary line), 4/5th
Intercostal space (Nipple line)
- Closed using trocha, Open using incision till muscle layer
11. List 5 Indication of Chest tube
- Pneumothorax spontaneous (closed) pneumothorax
- Traumatic open pneumothorax
- Tension pneumothorax
- Hemothorax
- Empyema/Effusions
- Chylothorax
12. How do you suspect Tension Pneumothorax and its Immediate managements in Trauma, List 5
- Tachycardia, Hypotension , Respiratory distress, Tracheal deviation, Hyper-resonance
ipsilaterally, Diminished breath sounds ipsilaterally, EFAST
- Thoracocentesis at 2nd intercostal space
13. Definition of Massive Hemothorax and Flail Chest
- Massive Hemothorax : Blood loss in chest cavity 1500cc or more than 200cc/hr for 2-4
Hours
- Fractures of 2 or more ribs in 2 or more locations
14. Define Cardiac tamponade and Becks Triad
- Trauma causes accumulation of at least 75cc which impairs cardiac fillings resulting in
tamponade and obstructive cardiogenic shock
- Becks Triad : Muffled heart sounds, Hypotension and Distended neck vein
15. Define FAST literally and the probe locations accurately
- Focused Assesment with Sonography in Trauma
- Subxyphoid, RUQ (Hepatorenal/Morrisons), LUQ (Spleenorenal), Suprapubic (POD)
CT brain and Cervical clearance
16. Draw types of brain hemorrhages location

17. List all the need for Head CT Scan (Canadian and New Orleans Criteria)

18. Cerebral Resuscitation


- Head 30 degrees elevation, Normothermia, Keep patient sedated and relaxed, IV fluids to
keep MAP >80, Mannitol, Avoid hyperventilation (Normocapnia), Normoglycemia, Seizure propylaxis
(Phenytoin/Levitiracetam)
19. List all CT Cervical clearance (Nexus Criteria)
- No midline tenderness, No neurological deficit, Normal alertness, No intoxication, No painful
distracting injuries

RSI and Indication for intubation


20. List at least 5 indications for intubations
- GCS <8, Rapidly deteriorating GCS, Respiratory distress, Maxillofacial injuries/Polytrauma,
Repeated convulsions, Concurrent severe pulmonary edema or upper abdominal injury, Unilateral
dilated pupils
21. Define RSI accurately and Step by Step approach for RSI
- Rapid sequence intubation (RSI) is an airway management technique that produces inducing
immediate unresponsiveness (induction agent) and muscular relaxation (neuromuscular blocking
agent) and is the fastest and most effective means of controlling the emergency airway
- The 7 Ps of RSI are 1) Preparation, 2) Preoxygenation, 3) Pretreatment, 4) Paralysis with
induction, 5) Protection and positioning, 6) Placement with proof, and 7) Post-intubation
management
22. List 9 basic equipment needs for RSI
- MALESSSSS
23. Inducting agent for RSI and List down each of it with the doses
- Ketamine 1.5-2 mg/kg IBW
- Etomidate 0.3-0.4 mg/kg TBW
- Fentanyl 1-2 mcg/kg TBW
- Midazolam 0.1-0.2 mg/kg TBW
- Propofol 1-2 mg/kg IBW + (0.4 x TBW) (others simply use 1.5 mg/kg x TBW as the general
guide)
- Thiopental 3-5 mg/kg TBW
24. Medications used for Neuromuscular blocker, List down and its doses
- Suxamethonium 1-2 mg/kg TBW
- Rocuronium 0.6-1.2 mg/kg IBW
- Vecuronium 0.15-0.25 mg/kg IBW
25. List 5 Proofs of the placement of ETT
- Direct visualisation, ETCO2, SPO2, CXR, 5 Points ausculations, ETT Vapour, Equal chest rises
Fluid management in trauma
26. Draw table with types of Hypovolaemic Shock

27. The advantages and Disadvantages of Crystalloid and Colloid

Basic Principle wound managements


28. Goals of Wound Care
- Facilitate Homeostasis, Decrease tissue loss, Promote wound healing, Minimize scar
formations, Protect wound from trama or microbial contaminations, Reduce pain, Provide
psychological comfort
29. How to Manage the amputate parts
- Gently rinse off dirt and debris with clean water, if possible. Do not scrub.
- Wrap the amputated part in a dry, sterile gauze or clean cloth.
- Put the wrapped part in a plastic bag or waterproof container.
- Place the plastic bag or waterproof container on ice. The goal is to keep the amputated part
cool but not to cause more damage from the cold ice. Do not cover the part with ice or put it directly
into ice water