Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RESP 5017 > 3. Neonatal and Pediatric Oxygen Therapy and Airway Management > Flashcards

3. Neonatal and Pediatric Oxygen Therapy and Airway Management Flashcards

1
Q

What are 3 oxygen therapy devices unique to paediatric populations?

A

oxygen hoods, incubator oxygen delivery, blow by oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Flow (for nasal prongs) is based on what?

A

size of the patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

FiO2 for nasal prongs depends on the patients:

A

weight, tidal volume, RR, flow, FiO2 (set on blender)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Flow range for: premature, term, < 1 year, 1-4 years, > 4 years?

A

<0.2LPM, <0.5LPM, 0.2-2LPM, 0.5-3LPM, 0.5-6LPM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Incubator oxygen delivery has the ability to provide:

A

heat, humidity, and O2 therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the usual FO2 range with incubators?

A

23-40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is O2 delivered in an incubator?

A

incubator is connected to a 50psi O2 source and oxygen then floods the incubator to the set O2 concentration and is monitored by an internal O2 analyser

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is humidity added to oxygen hoods?

A

LVN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the set gas flows for oxygen hoods? What is the appropriate minimal flow to ensure CO2 clearance?

A

10-15LPM

minimum 7LPM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What MUST be monitored while using an oxygen hood?

A

SpO2, temperature, FiO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of patients are oxygen hoods usually used for?

A

patients with thick&dry secretions - postextubation, RSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List some anatomical differences in neonatal/paediatric airway.

A

occiput rounded, tongue relatively large for mouth/posteriorly placed, epiglottis omega-shaped and floppy, larynx higher in neck, vocal cords slant anteriorly, short neck, cricoid ring narrowest diameter, overall funnel shaped airway, narrow nares, larger adenoids/tonsils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the normal RR for a newborn?

A

40-60bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the normal minute ventilation of a newborn?

A

200ml/kg/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the normal O2 consumption for a newborn?

A

6-8ml/kg/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a normal compliance value for a newborn?

A

5-6ml/cmH2O

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is normal airway resistance for a newborn?

A

25-30cmH2O/L/sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are normal blood gas values for a premature neonate (< 37 weeks gestation)?

A

pH: > or equal to 7.25
PaCO2: 45-55
PaO2: 50-70
HCO3: 18-24

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are normal blood gas values for a term neonate (37 weeks - 1 month)?

A

pH: 7.30-7.40
PaCO2: 35-45
PaO2: 80-100
HCO3: 20-24

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the normal blood gas values for a child to adult (> 1 year)?

A

pH: 7.35-7.45
PaCO2: 35-45
PaO2: 80-100
HCO3: 22-26

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are normal saturation levels for a premature newborn (< 37 weeks)?

A

90-94%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are normal saturation levels for a term neonate (37 weeks-1 month)?

A

> or equal to 92%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are normal saturation levels for a child to adult (1 month-18 years)?

A

> equal to 92%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the most common cause of airway obstruction in unconscious neonatal/pediatric patients?

A

tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How can you optimize patient positioning for BVM/intubation?

A

offset the prominent occiput that promotes neck flexion/obstruction by placing a towel under the patients shoulders + perform a head tilt/chin lift
use jaw thrust in suspect C-spine injuries

26
Q

How do you size an OPA in children? What technique do you use to insert the OPA?

A

sized from the corner of the child’s mouth to the angle of the jaw
inserted using the anatomical technique

27
Q

How is an NPA sized in children? When is an NPA contraindicated?

A

length approximated by distance from the tip of the nose to the tragus of the ear
contraindicated in basal skull fracture or bleeding disorders

28
Q

List some indications for BVM.

A

apnea, gasping, HR < 100 (newborn)/< 60 (pediatric), impending respiratory failure, impending cardiac failure, inadequate oxygenation and/or ventilation

29
Q

List the 3 PPV devices for neonatal/pediatric popultions.

A

self-inflating bag, flow-inflating bag, T-piece resuscitator

30
Q

Can a self-inflating bag be used to provide CPAP to a spontaneously breathing patient? Why/why not?

A

no, the outlet valve will not open and provide flow unless very high negative inspiratory pressure

31
Q

What is the bag volume, age range, and weight range of a pediatric bag?

A

500-900ml, 1-10 years, 10-30kg

32
Q

What is the bag volume, age range, and weight range of an infant bag?

A

250-350ml, < 1 year, < 10kg

33
Q

What does a flow-inflating bag require? Can CPAP be applied?

A

requires a gas source and an adequate seal
PEEP/CPAP can be applied and controlled by the flow coming into the bag (10 LPM) and how much gas is let out of the flow control valve

34
Q

List some indications for intubation.

A

pulmonary function (apnea, bradycardia, resp. failure, resp. distress with inadequate oxygenation/ventilation), provide an airway (a/w obstruction, protect a/w, loss of a/w reflexes, decreased LOC/OD), pulmonary hygiene (inability to clear secretions), administer medications (surfactant, epinephrine)

35
Q

What are the 3 main categories of drugs used for intubation?

A

sedative/analgesia, muscle relaxants, adjunctive therapies

36
Q

Which medication is used to prevent bradycardia/secretion production?

A

atropine

37
Q

What medications acts as an analgesics? Special considerations?

A

Fentanyl and morphine

*fentanyl needs to be pushed slowly (typically over 5 min)

38
Q

Which medications can be use as paralytics? Depolarizing or Non-depolarizing?

A

succs (depolarizing), roc (non-depolarizing)

39
Q

What is the acronym used when preparing for intubation? What does each letter stand for?

A 
SOAP ME
S - suction
O - oxygen
A - airway
P - pharmacology
ME - monitoring equipment
40
Q

For a neonate weighing < 1000g and approx. < 28 weeks will require what type of ETT? Size? Blade type?

A

uncuffed, 2.5, Miller 00 or 0

41
Q

For a neonate weighing 1000-2000g and approx. 28-34 weeks will require what type of ETT? Size? Blade type?

A

uncuffed, 3.0, Miller 0

42
Q

For a neonate > 2000g and approx. > 34 weeks will require what type of ETT? Size? Blade type?

A

uncuffed, 3.5, Miller 0 or 1

43
Q

How do you determine neonatal oral ETT depth?

A

measure nasal septum to the ear tragus (an add 1 cm) OR 6cm + weight in Kg
*for nasal intubations add 1 cm to above methods

44
Q

What is the recommended age to begin the use of cuffed ETT?

A

1 month +

45
Q

What are the benefits of a cuffed ETT?

A

decrease the chance of aspiration, minimize leak around ETT to enhance ventilation

46
Q

What is the optimal cuff pressure?

A

20-25cmH2O or MOV, but can also leave deflated if there is no leak

47
Q

How do you determine the ETT size for UNCUFFED?

A

age (years)/4 + 4

48
Q

How do you determine the ETT size for CUFFED?

A

Age (years)/4 + 3.5

49
Q

How do you determine the oral ETT depth for children > 2 years?

A

ETT size x 3 OR age/2 + 12

50
Q

How does a miller blade differ from a Mac blade?

A

miller blades directly pick up the epiglottis (floppy epiglottis in infants/children) vs. mac blade is placed in the valecula

51
Q

What is the purpose of Broselow Tape?

A

length-based resuscitation tape used to determine sizes for airway equipment

52
Q

List some ways in which an RT can confirm ETT placement.

A

visualization of ETT passing through vocal cords, bilateral BS, misting of ETT, bettering vital signs, end tidal CO2, CXR

53
Q

What is the name of the method used to tape the ETT in children < 6 years?

A

pant leg method

54
Q

What are the benefits of nasal intubation in infants?

A

easier securing of ETT, free mouth, better for long-term intubation

55
Q

List some things that will make for a difficult intubation.

A

recessed jaw, large tongue, floppy epiglottis, small mouth opening, neck mobility, anterior vocal cords, congenital tracheal malformations, glottic stenosis, subglottic stenosis

56
Q

List some indication for endotracheal suctioning.

A

abnormal BS, decreased SpO2, rattling in chest, abnormal ventilator waveforms, decreased/inadequate chest rise, agitation

57
Q

Describe the open vs closed method used for endotracheal suctioning.

A

open - use of a regular suction catheter

closed - inline (Ballard style)

58
Q

What are the suction pressures for a neonate/infant vs. child?

A

neonate/infant - 80-100mmHg

peds - 100-120 mmHg

59
Q

To what depth should an RT suction down a ETT?`

A

1/2 cm past the end of ETT

*line up color markings on suction catheter with window

60
Q

In the case of a sudden event post-intubation, what is the acronym used to find the problem? What does each letter stand for?

A 
H-DOPE
H - handbag/auscultate
D - displacement
O - obstruction
P - pneumothorax 
E - equipment

RESP 5017 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions