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Discussion Questions
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1. Review the anatomy of the larynx. Sketch out the main structures you’ll see looking down into the airway as though intubating the patient. Feel free to use the sketch pad.
2. Orient the specimen at the start of the video (0:00). Which side is anterior, posterior, right and left?
3. Identify where the esophagus would lie at the start of the video (0:00).
4. Orient the specimen at 0:05. Which side is anterior, posterior, right and left?
5. Identify where the esophagus would lie at 0:05.
6. Identify the hyoid bone, true vocal cords, false vocal cords, epiglottis, cuneiform tubercle, corniculate tubercle and arytenoids.
7. According to the history, how many attempts at intubation were there?
8. Were any successful?
9. What evidence is there of these attempts?
10. Were these attempts always directed into the laryngeal inlet? If not, where were the attempts directed?
11. Why did the patient need multiple attempts at intubation?
12. Why did the patient need increasingly smaller size endotracheal tubes?
13. Could the emergency team have known the patient would have been difficult to intubate?
14. Why was the patient difficult to intubate? Was this a congenital or acquired condition?
15. How is the patient’s anatomic abnormality related to his cause of death?
16. How would you define “competence” when caring for a patient? Does competence mean saving every life?
17. When is it ok to ask for help treating a patient?
18. You are called insert an IV on a patient. After how many tries would you stop trying to insert an IV in one location and switch to another location? When would you stop trying to insert an IV and ask for help?
19. Does your hospital have a policy for number of “IV tries” before getting help?
20. You are called to intubate a patient. How many attempts at intubation would you make before asking for assistance?
21. When, in a hospital setting, would you call in an anesthesiologist to assist with intubation?
22. What evidence is there, if any, that the person intubating perhaps should have asked for help?
23. Could the patient’s death have been prevented?
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