Airway Equipment, Supraglottic Airway Devices, and Tracheal Intubation Instrumentation — WACS Viva & Clinical Scenarios (Clinical Measurement and Equipment)

Exam-style airway equipment, supraglottic airway devices, and tracheal intubation instrumentation viva scenarios with examiner probes and model answers for…

Scenarios covered

• SCENARIO 1: A 34-year-old male presents for emergency drainage of an extensive submandibular space infection (Ludwig angina) with bilateral swelling, floor-of-mouth elevation, severe trismus (inter-incisor distance 1.2 cm), and stridor when supine. You have an anaesthetic machine, basic laryngoscopes, a flexible fiberoptic bronchoscope with an external battery pack, local anaesthetic solutions with mucosal atomizers, and a scalpel-bougie cricothyroidotomy kit. Outline your anaesthetic and airway instrumentation strategy to secure this patient's airway safely.
• SCENARIO 2: A 28-year-old primigravida at 39 weeks gestation with severe pre-eclampsia and fetal distress is scheduled for emergency Caesarean section under general anaesthesia due to coagulopathy. Following rapid sequence induction with thiopental and suxamethonium, you perform direct laryngoscopy with a Macintosh size 3 blade and observe a Cormack-Lehane Grade 4 view. A second attempt with an optimized head position, external laryngeal manipulation, and a gum elastic bougie also fails to locate the glottis. Face mask ventilation yields severe air leak with falling oxygen saturation (SpO₂ 84%). Detail yo
• SCENARIO 3: A 45-year-old female presents for total thyroidectomy for a multinodular goitre causing significant tracheal compression (internal diameter narrowed to 6 mm on computerized tomography scan) and deviation. Detail your choice, sizing, inspection, preparation, and intraoperative troubleshooting of the tracheal tube, including strategies to manage post-extubation tracheomalacia.
• SCENARIO 4: A 62-year-old male with severe ischemic cardiomyopathy is undergoing elective laparoscopic cholecystectomy. You select a second-generation supraglottic airway device for airway maintenance. Five minutes into peritoneal insufflation, the ventilator alarms high peak airway pressures (36 cmH₂O), the capnograph demonstrates an irregular waveform with loss of end-tidal plateau, and the measured tidal volume drops from 480 mL to 210 mL. Explain your anaesthetic evaluation, diagnostic approach, and corrective actions regarding this airway device.
• SCENARIO 5: A 5-year-old child weighing 16 kg is scheduled for repair of a post-burn flexion contracture of the neck, fixing the chin firmly to the anterior chest wall. There is no neck extension, and the mouth opening is limited to 1.5 cm. Outline your complete anaesthetic evaluation, preparation of specialized pediatric airway instrumentation, induction technique, and contingency plans.