| Show Learning Points most relevant to Phase 1: |
Compromised airway
| Clinical Discipline(s)/Organ System(s) Emergency Medicine, Immunology, Intensive Care Medicine, Otorhinolaryngology, Anaesthesiology | Progress Test Topic(s) ENT, Seriously ill patient |
Description
A 54 year old Tongan man with known nut allergy presents with difficulty breathing. His throat feels swollen and he is very distressed. It all started when he ate at a restaurant.
Progress Test-Type Questions: Question 1 | Question 2Applied Science for Medicine
- Anatomy of the entire airway-upper and lower; microanatomy of airways
- Cellular and cytokine controls of inflammation
- Different types of hypersensitivity reaction
- Physiology of acute airway obstruction; intra- vs extra-thoracic, focal vs diffuse airflow obstruction
- Microbiology of haemophilus influenza B
- Pharmacology of antihistamines and adrenaline; cross-reactivity of medications
- Anatomy of the entire airway-upper and lower; microanatomy of airways
- Cellular and cytokine controls of inflammation
- Different types of hypersensitivity reaction
- Physiology of acute airway obstruction; intra- vs extra-thoracic, focal vs diffuse airflow obstruction
- Microbiology of haemophilus influenza B
- Pharmacology of antihistamines and adrenaline; cross-reactivity of medications
Clinical and Communication Skills
- Recognise, assess and manage a compromised airway, including maneouvres, adjuncts and definitive airways
- History or a collateral history for a patient with breathing difficulties
- Communicate in a way that enables the patient to keep as calm as possible
- Take an allergy history
- Examination of a patient with breathing difficulties; recognise the signs impending airway obstruction
- Differential diagnosis of upper airway compromise
- Indications for laryngoscopy, flexible bronchoscopy, surgical airway manoeuvres, C1 esterase, antigen-specific IgE
- Interpret full blood count, serum tryptase, serum lactate, arterial blood gas, blood cultures, sputum cultures, C1 esterase levels , antigen-specific IgE
- Perform arterial blood gas and intramuscular injection
- Management of anaphylaxis, epiglottitis, angioedema and foreign body obstructing an airway
- Indications for an adrenaline autoinjector (such as EpiPen) and medical alert bracelet
- Educate, at an appropriate time, about prevention of anaphylaxis and self-management
- Recognise, assess and manage a compromised airway, including maneouvres, adjuncts and definitive airways
- History or a collateral history for a patient with breathing difficulties
- Communicate in a way that enables the patient to keep as calm as possible
- Take an allergy history
- Examination of a patient with breathing difficulties; recognise the signs impending airway obstruction
- Differential diagnosis of upper airway compromise
- Indications for laryngoscopy, flexible bronchoscopy, surgical airway manoeuvres, C1 esterase, antigen-specific IgE
- Interpret full blood count, serum tryptase, serum lactate, arterial blood gas, blood cultures, sputum cultures, C1 esterase levels , antigen-specific IgE
- Perform arterial blood gas and intramuscular injection
- Management of anaphylaxis, epiglottitis, angioedema and foreign body obstructing an airway
- Indications for an adrenaline autoinjector (such as EpiPen) and medical alert bracelet
- Educate, at an appropriate time, about prevention of anaphylaxis and self-management
Personal and Professional Skills
- Self-care: coping under pressure and the ability to reflect in action
- Manage an emergency situation; ability to work effectively in a team in an emergency situation including either leading or taking directions
- Behave in a way that inspires confidence and reduces patient anxiety
- Self-care: coping under pressure and the ability to reflect in action
- Manage an emergency situation; ability to work effectively in a team in an emergency situation including either leading or taking directions
- Behave in a way that inspires confidence and reduces patient anxiety
Hauora Māori
- Ethnic disparities in food allergies and in allergy testing in New Zealand
- Appropriate engagement and consultation with whānau
- Ability to cater for differential health literacy needs of Māori patients and whānau
- Consideration of access to cultural/spiritual support for patient and whānau
- Ethnic disparities in food allergies and in allergy testing in New Zealand
- Appropriate engagement and consultation with whānau
- Ability to cater for differential health literacy needs of Māori patients and whānau
- Consideration of access to cultural/spiritual support for patient and whānau
Population Health
- Epidemiology of serious food allergy: time trends, risk factors, opportunities for prevention
- Epidemiology of serious food allergy: time trends, risk factors, opportunities for prevention
Conditions to be considered relating to this scenario
Common
anaphylaxis, food allergy, foreign body, peritonsillar abscess/quinsy, trauma
anaphylaxis, food allergy, foreign body, peritonsillar abscess/quinsy, trauma
Less common but 'important not to miss'
laryngeal squamous cell carcinoma, epiglottitis/supraglottitis, angioedema, vocal cord paralysis, smoke inhalation, Ludwig's angina
laryngeal squamous cell carcinoma, epiglottitis/supraglottitis, angioedema, vocal cord paralysis, smoke inhalation, Ludwig's angina
Uncommon
deep neck space infection, diphtheria
deep neck space infection, diphtheria
