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Airway Complication Evaluation
Each participant is requested to complete this evaluation tool as a way to assess the
effectiveness of his/her learning following his/her participation in the program.
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* Indicates required question
Name:
*
Your answer
AANA #
*
Your answer
Email Address:
*
Your answer
Date:
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MM
/
DD
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YYYY
Indicate your level of achievement for each learner objective on the rating scale.
Select One
Discuss the extent of oral injuries during airway management each year.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
List at least five reasons why providers fail to optimize patient positioning prior to intubation.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
Discuss the proper way to insert a video laryngoscope, specifically when to look from the tube and oral airway to the screen.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
List at least four risk factors for tracheal rupture.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
List signs and symptoms of tracheal rupture.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
Explain why early diagnosis of esophageal perforation is critical.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
List the factors that predispose a patient to esophageal perforation.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
Explain the ways in which tongue necrosis can occur.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
List the factors related to surgery and anesthesia that can contribute to tongue necrosis.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
Explain the possible long-term outcomes of tongue necrosis and the possible implications for the patient.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
Discuss what the anesthesia provider can do to reduce the risk of tongue necrosis.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
Detail the causes of vocal cord paralysis.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
Explain how to avoid intubation related laryngeal nerve injury.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
List at least five potential complications of nasal intubation.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
Discuss methods for causing nose bleeds during nasotracheal intubation.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
Explain the actions to take on detection of an injury during nasotracheal intubation.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
List a minimum of three rare medical conditions that can predict unexpected airway abnormalities.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
Discuss what can cause an obstruction of an ETT.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
List a minimum of four factors that can predispose a patient to unplanned extubation.
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1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
Discuss four or more clinical complications associated with unplanned extubation.
*
1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
The information provided was effective in presenting the material.
*
1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
Teaching methods were effective.
*
1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
Online learning format facilitated learning.
*
1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
The content was related to the objectives.
*
1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
My personal learning objectives were met.
*
1. Excellent
2. Good
3. Adequate
4. Fair
5. Poor
State one item you learned that will improve your nurse anesthesia practice.
*
Your answer
State any barriers to implement this change.
*
Your answer
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