Advanced Airway Flashcards
2 goals of airway
Oxygenation and ventilation
How do you know if they are oxygenated and ventilating
End title
LEMONS
To identify difficult intubation
Look externally
Evaluate 3:3:2
Mallampati
Obstruction/ Obesity
Neck mobility
Saturation/ Situation
SMART
Difficult Cricothyrotomy
Surgical history
Massive neck adipose
Assess anatomy
Radiation
Tissue landmarks
CPAP Indication
CHF with SBP above 90
Near drowning
Pneumonia
Asthma/ COPD
Neuromuscular disorder
CPAP Contra
Increased secretions
Head trauma/ ICP
Penetration to chest/ pneumothorax
Explosive barotrauma
NIPPV
Non invasive positive pressure ventilation
Common pediatric airway infections
Epiglottitis
Croup
Bacterial tracheitis
Retro pharyngeal abscess
Ludwig’s angina
Epiglottitis
Swelling of the epiglottis from infection that can become an airway obstruction
S/S - drooling, lack of coughing, stridor
Croup
Infection of the upper airway (usually viral) may spread to bronchi
S/S - stridor with a cough (barking cough)
Bacterial tracheitis
Bacterial infection of trachea
S/S - fever, cough, drooling, harsh vibrating noise from larynx when breathing
Retropharyngeal abscess
Collection of pus in back of throat
S/s- fever, stiff neck, noising breathing
Ludwig’s angina
Life threatening cellulitis of soft tissue in neck and floor of mouth
S/s- swelling to neck, tongue, cheeks, jaw
Common obstructions to pediatric airways
Foreign body
Burns
Anaphylaxis
Trauma
Common congenital abnormalities for Ped airway
small chin
large tongue
limited mouth opening
small neck
BVM 1 breath every ____ sec for ped
3
BVM 1 breath every ____ sec for adult
6
formula to select an uncuffed ET tube size for ped
(AGE/4) +4
*go down half a size for cuffed
What form of shock lowers end title
All!!!!
Normal end title range
35-45
Desired end title range for ICP
30-35
Normal end title waves
Boxes
Hypoventilation wave form
Long squares
Hyperventilation wave form
Quick squares
Asthma wave form
Will look like shark fins
Mild- increase RR with low ETCO2
Moderate- decreased RR with normal ETCO2
Severe- really slow RR with high ETCO2
3 types of COPD
Asthma- pathway problem
Bronchial- pathway problem
Emphysema- alveoli problem
ETCO2 wave form that trails off…
Bad seal
Blown cuff
ETCO2 that looks like tents…
Obstruction
How do you find MAP
(SBP + 2(DBP) )/3
What is a good MAP and what does it mean
65 meaning the pts pressure is good enough to perfuse
