29.3 Airway Flashcards
What must be administered to all trauma patients?
Supplemental oxygen
Primary involuntary respiratory center
Medulla
What is connected to the respiratory muscles by the Vagus nerve?
The pons
What factors can change respirations
a)Body temperature increases respiration.
b)Emotion increases respiration.
c)Pain increases respiration.
d)Hypoxia increases respiration.
e)Acidosis increases respiration.
f)Stimulant drugs increase respiration.
g)Depressant drugs, sleeping agents decrease respiration.
h)Drugs like Morphine will decrease respirations.
What is the term for when there is no oxygen available at all?
Anoxia
Literally means “deficient in oxygen”, that is an abnormally low oxygen availability to the body or an individual tissue or organ
Hypoxia
Insufficient oxygenation; that is decreased partial pressure of oxygen in blood.
Hypoxemia
Indications for O2 therapy are
(1) Cardiac and respiratory arrest
(2) Hypoxemia (pO2 < 58.5 mmHg, Sat < 90%)
(3) Hypotension (Systolic BP < 100 mmHg)
(4) Low Cardiac Output and Metabolic Acidosis (serum bicarbonate < 19 mmol/l)
(5) Respiratory distress (RR > 24/min)
What is the rate of oxygen supplied from a nasal cannula
Oxygen is supplied at rates of 1-6 liters/min resulting in inspired concentration of approximately 25-30%.
Which type of oxygen delivery device is used for the following:
1)Physical trauma
2)Chronic airway limitation/chronic obstructive pulmonary diseases
3)Cluster headache
4)Smoke inhalation
5)Carbon monoxide poisoning
Non-rebreather mask
Which type of oxygen delivery device is used for the following:
a)Decompression illness (the “bends”)
(b)Carbon monoxide poisoning
(c)Radiation necrosis
(d)Reconstructive surgery
(e)Some infection, wounds
Hyperbaric Oxygen
Steps for Manual Clearing of the Airway
1)The first step in airway management is a quick visual inspection of the oropharyngeal cavity.
2)Foreign material (e.g., pieces of food) or broken teeth and blood may be found in the mouth of a trauma casualty.
3)These are swept out of the mouth using a gloved finger or, in the case of blood or vomitus, may be suctioned away.
4)Prolonged suctioning should be avoided to eliminate the potential for hypoxemia, while administration of oxygen prior to suctioning may also prevent hypoxemia due to suctioning.
What is the most common cause of airway obstructions
Tongue
What manuever is used during BVM ventilation and aids in preventing aspiration
Sellick Maneuver
What is the BURP maneuver
- Backward, upward, and rightward pressure on the larynx.
- The maneuver improves the visualization of the larynx structures and eases the intubation.
What is the most frequently used artificial airway device
Oropharyngeal Airway (OPA).
Indications for OPA
1)Casualty who are unable to maintain their airway.
2)Casualty whose tongue continues to fall into the back of pharynx causingairway obstruction.
3)To assist in improving ventilation in patient’s that are being ventilated with a BVM.
4)It also prevents an intubated casualty from biting an ET tube.
Contraindications for OPA
Casualty who is conscious or semiconscious.
Contraindication for NPA
Basilar skull fracture
What is the preferred supraglottic airway because it makes it simpler to useand avoids the need for cuff inflation and monitoring
I-gel
Sizes for I-gel
Size 4 is the correct size for the typical adult.
Size 5 is used for adults larger than 200 pounds.
Indications for ET Tube
(a)Casualty who is unable to protect their airway.
(b)Casualty with significant oxygenation problem, requiring administration of high concentrations of oxygen.
(c)Casualty with significant impairment in ventilation requiring assisted ventilation.
(d)Cardiac arrest.
(e)Severe hemorrhagic shock.
The following conditions require caution before attempting to intubate:
1)Ingestion of caustic substances
2)Mandibular fractures
3)Laryngeal edema
4)Thermal or chemical burns
Complications with ET Tube
(a)Hypoxemia from prolonged intubation attempts.
(b)Trauma to the airway with resultant hemorrhage.
(c)Right mainstem bronchus intubation.
(d)Esophageal intubation.
(e)Vomiting leading to aspiration.
(f)Loose or broken teeth.
(g)Injury to vocal cords.
(h)Conversion of a cervical spine injury without neurologic deficit to one with neurologic deficit.
