1356 Exam Flashcards
What is the most common size ET tube for a female?
7.0 (7.5 for obese woman)
What is the most common size ET tube for a male?
8.0 (8.5 for obese man)
ET tube size depth measured by:
tube size x 3cm at the teeth.
ET tube placement in the trachea should result in:
chest rise
If tube mark is too far its a:
right mainstem
If a tube mark is too short its an:
esophagus.
What is the most effective securing device for an ET tube?
Commercial device
What happens when an OPA is too short?
creates tongue obstruction
What happens when an OPA is too long?
Creates epiglottis obstruction
When responding to a chocking patient, first:
confirm choking then begin back blows or Heimlich chest thrusts.
If/when a choking patient goes unconscious:
begin CPR
A patient with this is complaining of SOB
respiratory distress
A patient with this breathing problem may present with altered LOC and/or unresponsive.
Respiratory failure
What defines adequate breathing?
good chest rise and fall, breathing 12-20 times a minute/pulse oximetry >96%.
What defines inadequate breathing?
No rise and fall of the chest, unable to talk.
What is the pulse ox reading?
saturation of oxygen on hemoglobin. Based on saturation percentage. SA02
What is PO2?
Partial oxygen concentration (pressure reading)
What is the purpose of listening to breath sounds?
Making sure air is moving in and out/listening for inappropriate noises such as stridor, wheezing, rales, etc.
What are the steps for deep suction?
Go all the way down and suction on the way back up. Max 10-15 seconds of suction. Usually measured from lips to earlobe.
What medical emergencies are indications for intubation?
cardiac arrest, respiratory failure w/o gag reflex, inadequate rise and fall of the chest.
Describe king tube
2 cuffs and 1 pilot ballon
Describe LMA tube
1 cuff and 1 pilot
Describe ET tube
1 cuff and 1 pilot balloon.
Describe Combi Tube
2 cuffs and 2 pilot balloons.
____: performed by applying gentle pressure to the anterior neck (in a posterior direction) at the level of the cricoid cartilage.
Sellick maneuver.
_____ is most often used to help align the airway structures during endotracheal intubation.
Sellic maneuver.
What is the maneuver called that moves the chin and forehead to open the airway?
head tilt chin lift.
What maneuver is used to open the airway when a patient has a cervical collar on?
Modified jaw thrust.
The maneuver uses the index finger at jaw to push forward and tilt the head back:
Modified jaw thrust.
What does clear fluid in the patients mouth possible indicate?
Basal skull fracture where CSF is leaking out.
What are the three ways we check for adequate breathing?
look, listen, and feel.
short and explosive, bubbling or drinking. Located typically in the lower airway but can be high. Happens during inhalation.
Rales
Low pitched wheezing while breathing out, rubbing.
Rhonchi
Harsh, squeaking with every breath (blocked upper airway)
Stridor
High pitched whistling (lower airway)
Wheezing.
Gasp followed by long bout of coughing.
Whooping.
What is the best way to secure and ET tube?
Commercial/manufacture device that has integral bite block.
How is a stroke patients airway managed?
See if they can maintain their own airway. Gag then bag. Gag reflex then bag, but if no gag then RSI. BLS first.
Breathing too fast
hyperventilation
Breathing too slow
Hypoventilation
Choking patient with partial obstruction:
Coughing vs full obstruction with no coughing.
How is a complete airway obstruction with unconscious patient handled?
Either use forceps to try and reach in to retrieve the object. Use an ET tube and shove the object down, but if all else fails, do CPR.
How is a nasal intubation timed?
ET tube is pushed in conjunction with the patients own breathing.
What is an indication that a patient with respiratory distress is improving?
rising SPO2.
What is the cycle of blood through the vascular system? (heart)
Deoxygenated blood comes from the vena cava into the RA, RA to RV, RV to pulmonary arteries where the blood is oxygenated by the lungs and CO2 is breathed off, then to the LA, LA to LV, LV to the aorta and pushed through the peripheral vascular system.
When is soft suction used?
With a ET tube.
When is rigid suction used?
To suction the mouth (not the tube)
What is the normal capnography range?
35-45
What does the wave form look like for a patient not in respiratory distress?
box
What would you expect to hear from a drowning patient?
Bubbling or gurgling with poor BVM compliance.
What does a shark fin indicate for breathing waveform?
bronchospasm.
______= breaths per min x tidal volume
average tidal volume.