The Difficult Adult Airway, Rapid Sequence Induction, and Aspiration Prophylaxis in General Anaesthesia — WACS Viva & Clinical Scenarios (General Anaesthesia)

Exam-style the difficult adult airway, rapid sequence induction, and aspiration prophylaxis in general anaesthesia viva scenarios with examiner probes and…

Scenarios covered

• SCENARIO 1: A 42-year-old male with a body mass index (BMI) of 44 kg/m², short muscular neck, Mallampati Class IV airway, and thyromental distance of 4.5 cm presents for emergency open appendicectomy for perforated appendicitis with general peritonitis. Outline your comprehensive airway evaluation, aspiration prophylaxis, and induction technique.
• SCENARIO 2: You are inducing an elective 50-year-old female for total thyroidectomy. After administration of propofol and rocuronium, you perform direct laryngoscopy and visualize only the epiglottis tip resting against the posterior pharyngeal wall (Cormack-Lehane Grade 3b). Face-mask ventilation is possible but difficult (SpO₂ dropping to 91%). Detail your step-by-step management algorithm.
• SCENARIO 3: A 28-year-old polytrauma victim with active facial bleeding, a rigid abdomen, and an immobilized cervical spine requires immediate emergency laparotomy. Outline your approach to securing the airway while protecting the cervical spine and preventing pulmonary aspiration.
• SCENARIO 4: During rapid sequence induction of a 60-year-old male with mechanical bowel obstruction, direct laryngoscopy and videolaryngoscopy both fail due to copious vomitus flooding the pharynx. Attempted rescue ventilation with a second-generation supraglottic airway fails, and face-mask ventilation generates no chest rise with SpO₂ falling to 65% and heart rate dropping to 40 bpm. Walk the panel through your emergency action plan.