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Patient Care > Advanced Airway Management > Flashcards

Advanced Airway Management Flashcards

1
Q

Laryngeal Structures

A

Hyoid Bone
Thyrohyoid Membrane
Thyroid Cartilage
Cricothyroid Ligament
Cricoid Cartilage
Trachea

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2
Q

Pharyngeal tonsil

A

Adenoids

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3
Q

Epiglottis

A

Flap of elastic cartilage tissue
Guards entrance of the glottis, opening between vocal cords

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4
Q

Vocal Cords

A

Twin in-foldings of mucous membranes stretched across the larynx

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5
Q

CATHE

A

Inferior to superior of larynx

Cricoid cartilage
Arytenoid Cartilage
Thyroid Cartilage
Hyoid Bone
Epiglottis

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6
Q

Innervation of Larynx

A

Vagus Nerve

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7
Q

Vagus Nerve Stimulation

A

Decreases HR, BP, RR
Risk of stimulation with intubation/overinflation of king LT

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8
Q

Indications King LT

A

Need for ventilatory assistance/airway control

Other airways ineffective

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9
Q

Conditions King LT

A

GCS 3 w/o gag reflex

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10
Q

Contraindications King LT

A

Active vomiting
Inability to clear airway
Airway edema
Stridor
Caustic Ingestion

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11
Q

Medications which can go down King LT

A

Ventolin

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12
Q

Advantages of LMA

A

Minimal soft tissue trauma
Lower tidal volumes
Decreased gastric insufflation
Unaffected anatomical factors
Less coughing and laryngospasm
Decreased sympathetic response
Better tolerated

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13
Q

Disadvantages of LMA

A

No protection for aspiration/bleeding
Mouth required to be opened >0.6”
Difficult to adequately ventilate if needing high airway pressure
Not effective if airway anatomy abnormal

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14
Q

Contraindications of King LT

A

Risk of aspiration
High airway resistance
Presence of tumours, abscess, hematoma

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15
Q

Considerations for ETT

A

Failure to protect airway, failure of ventilation/oxygenation

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16
Q

Indications for ETT

A

Need for ventilatory assistance or airway control, other airways ineffective

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17
Q

LEMON

A

Look Externally
Evaluate 3-3-2
Mallampati
Obstruction
Neck Mobility

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18
Q

Look Externally

A

Beard
Moustache
Abnormal facial shape
Facial disruption by trauma
buck teeth
Obesity
Craniofacial abnormality
Neck mass
Large tongue
Trauma

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19
Q

3-3-2 Rule

A

3 Fingers between teeth
3 fingers from mentum to hyoid
2 fingers between hyoid and thyroid notch

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20
Q

Mallampati 1

A

Uvula, soft palate, faucial pillars visible

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21
Q

Mallampati 2

A

Uvula partially blocked by tongue, soft palate + faucial pillars visible

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22
Q

Mallampati 3

A

Soft palate visible, base of uvula may be visible, no other structures visible

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23
Q

Mallampati 4

A

Hard palate only visible

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24
Q

Obstruction

A

Laryngeal tumour
Evidence of airway obstruction
Epiglottitis
Peritonsillar abscess
Foreign body
Airway trauma
Noisy breathing
Inflammation

25
Q

Neck Mobility

A

Reduced in elderly, arthritis, immobilization

26
Q

BONES

A

BVM assessment
Beard
Obese
No teeth
Elderly
Snores

27
Q

MOANS

A

BVM assessment
Mask seal
Obesity
Age
No teeth
Stiff

28
Q

SLOPES

A

Suction, stylet
Laryngoscope, lube, lidocaine
Oxygen, OPA, Otrivin
Pillow/Positioning
ETT/ETCO2
Stethoscope, syringe, securing device

29
Q

ETT tube sizing children

A

Age/4 + 4

30
Q

ETT Depth to teeth child >2

A

Age/2 + 12

31
Q

ETT Depth

A

Tube size x 3

32
Q

Cormack and Lehane Scale

A

Grade 1: Full view
Grade 2: Epiglottis and arytenoids only
Grade 3: Epiglottis only
Grade 4: cannot see epiglottis

33
Q

Sellick’s Maneuver

A

Protect from regurgitation/aspiration
10lbs pressure
Release if vomiting occurs to prevent esophageal rupture
Maintain until cuff inflated
Controversial if effective

34
Q

Awake Intubation

A

GCS <8
Lidocaine 10mg/spray
Max 5mg/kg to 20 sprays

35
Q

Confirmation of ETT Placement

A

ETCO2
Visualization
Auscultation
Chest rise
Misting
Syringe aspiration
SpO2

36
Q

ETT Attempt

A

Insertion of laryngoscope for purpose of intubation

37
Q

ETT Need For Sedation

A

Monitor HR and BP
Gagging
ETCO2

38
Q

Indications for Procedural Sedation

A

Post-intubation, transcutaneous pacing

39
Q

Conditions Procedural Sedation

A

> 18
RR >10 (non-intubated)
Normotension

40
Q

Treatment Procedural Sedation

A

Midazolam
2.5-5mg
Max 5mg/dose
Total 10mg
2 doses 5 min apart

41
Q

ETT Complications

A

Esophageal intubation
Vomiting
Aspiration
Right mainstream intubation
Inability to intubate
Loss of adaptor
Torn cuff
Dysrhythmias
Laryngospasm
Increased ICP
Hypoxia
Trauma
Flooded airway

42
Q

Trouble Shooting ETT Compliance

A

DOPE BP
Displacement
Obstruction
Pneumothorax
Equipment
Bronchospasm
Pulmonary Edema

43
Q

Esophageal obstruction

A

Treat with 1.0mg glucagon IV

44
Q

Laryngospasm

A

Involuntary closure of glottic opening resulting in partial or complete airway obstruction

45
Q

Causes of Laryngospasm

A

Extubation
Intubation/airway manipulation
ENT procedures
Fluids
Foreign body
Aspiration
Reflux
Near drowning

46
Q

Larson’s Point

A

Laryngospasm notch
Break laryngospasm by applying painful anterior pressure at larson’s point bilaterally while performing jaw thrust

47
Q

Indications Digital Intubation

A

Trauma
Obese or short necked pts
Secretions or bleeding obscures visualization

48
Q

Pros of Digital Intubation

A

Fast
No requirement for positioning
Minimal C-spine movements for trauma pts
Ideal for those predicted to be difficulty airways
Used for copious secretions/blood and cannot visualize

49
Q

Cons of Digital Intubation

A

Requires training
Being bit by pt
Airway trauma
Pt must be paralyzed or comatose/dead
Benefits those with long, slender fingers

50
Q

Pickaxe/Tomahawk method

A

For trauma scenarios
In awkward situation

51
Q

Times for Blind nasal intubation

A

C-spine injury
Airway control in conscious pt
Trismus
Significant head injury

52
Q

Advantages nasal intubation

A

Better tolerated
No laryngoscope
Easier positioning
Awake pt
Pt cannot bite tube or manipulate with tongue

53
Q

Disadvantages nasal intubation

A

Increased airway pressure
Limited compatibility
Epistaxis
Vocal cord trauma
Infection

54
Q

Contraindications Nasal Intubation

A

<50 and asthma exacerbation not in or near cardiac arrest
Basal skull fracture
Uncontrolled epistaxis
Bleeding disorders

55
Q

Complications of nasal intubation

A

Epistaxis
Damage to nasal cavity
Aspiration
Vagal stimulation
Laryngospasm
Vocal cord damage

56
Q

Reasons for Tracheostomy

A

Bypass obstruction
Remove secretions
Oxygen delivery
Trauma/airway complications

57
Q

Cricothyrotomy

A

Emergency airway procedure
Between cricoid and thyroid cartilages through the cricothyroid membrane

58
Q

DOPES trach emergency

A

Displacement of tube
Obstruction of tube
Patient
Equipment
Stacked breaths

Patient Care (11 decks)

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