86 - 90 SBAs for the Final FRCA
Question 86
A 68 year old male smoker is scheduled for a thoracoscopic wedge resection.
Which of the following is an advantage of a double lumen tube when compared with a bronchial blocker?
- Less prone to airway trauma
- Allows selective lobar isolation
- Quicker to insert
- Easier to use when postoperative ventilation is likely to be needed
- More suitable for patients with tracheostomies
Answer
- Quicker to insert
Double lumen tubes are usually quicker to insert than a bronchial blocker, and are also less prone to becoming displaced. They may however cause more hoarseness and have a higher risk of airway trauma.
Bronchial blockers also allow for selective lobar isolation as you can pick a specific airway to plonk it in, which double lumen tubes do not.
Bronchial blockers are also helpful if postoperative ventilation is anticipated, as you can simply pull them out at the end, leaving the standard ET tube (or tracheostomy) in place.
Question 87
You're about to insert a left sided double lumen tube when your consultant asks you how deep you're intending to insert it into this 170 cm adult.