132 test 1-airways/ippb Flashcards
Name Indications for E-T Tubes?
Failure to ventilate/oxygenate respiratory failure need to protect airway airway compromised predation of decomposition airway obstruction
What are some things that cause ventilatory failure?
Drugs
Midbrain Abnormalities
Disease of respiratory muscles
In this disease acetylcholine becomes absent; causing inaction of neural junction
Myasthenia Gravis
This disease de-mylenates nerve sheath by immune system & causes paralysis, begins as virus
Guillian Barre
Name symptoms of obstructed airway?
stridor, muscle exertion, accessory & intercostal muscles being used
Name the 4 protection reflexes?
Pharyngeal
Laryngeal
Tracheal
Carinal
Name the 2 types of cuffs that seal airway?
Low Volume, high pressure
High volume, low pressure
Which type of volume cuff is best?
High volume, low pressure because it helps preserve airway
What size ET is normally used in women & men?
Women: size 7-8
Men: 8-9
What should cuff pressure be set at?
20-25 mmHg
What is the max cuff pressure above the cuff?
20 cmH20
At what pressure is lymph flow impeded?
5 mm Hg
At what pressure is Venous flow obstructed?
Greater than 10 mmHg
At what pressure is arterial blood flow obstructed?
Greater than 30 mm Hg
What type of tube is used that is double lumen & can seal either the esophagus or trachea and oropharynx?
Combitube
What type of tube is used to ventilate only one side of lung?
Carlen Tube
What other type of airway device is often used for anesthesia to provide patent airway, sometimes used in emergencies?
LMA–Laryngeal Airway Device
What are some complications of E-T Tubes?
Poor secretion removal Loss of protective measures unable to talk could cause vocal cord paralysis Glottic edema Tracheal stenosis Treacheal Malacia
When viewing ET tube exernally where should the oral tube be sititng at teeth in mean & women?
21-23 cm for men
19-21 cm for women
Where does the ET tube get inserted?
Mid Trachea
2-4 inches above carina
Between T2-T4
What is the best method to confirm if ET tube is correctly placed?
Xray
What is best method to confirm if ET tube is correctly placed at bedside?
EasyCap
Which type of trach tube is best for ventilated patient, cuffed or uncuffed?
Cuffed
How often should inner cannulas of trach tube be changed?
Every 24 hrs
What are some conditions requiring trach tubes?
Traumatic upper airway obstruction Uncontrolled upper airway breathing Coma Patient unable to maintain ventilation Laryngeal & upper airway edema
Complications of trach tubes?
Laryngeal lesions
Failure to establish patent airway
Tracheal damage: stenosis, malacia
Why is routine aircare necessary?
Keep patent airway
Protect lower airway
Cough reflex is suppressed
How do you determine the catheter tube size?
Size x 2 and take next smallest size
What are results of too much pressure too long?
Tracheal Ischemia
Ulceration
Necrosis
What should the cuff pressure be set at?
20-25 mmHg
Why are tubes cuffed?
To seal the airway
