Advanced Airway Managment Flashcards
Why does airway managment fail
7 points
Lack of protocol Lack of planning or preparation Lack of plan - A/B/C Intubation failure Lack of equipment availability, use and training Approach Comms failure
What indicates respiratory failure on an ABG ?
PH <7.2
CO2 >55
PaO2<60
Only one value needs to be off to indicate the possible need to tube.
What age should a needle cric be performed ?
<8 yro
What does LEMON stand for ?
Look Evaluate - 3 fingers in mouth-3 fingers between jaw and hyoid - 2 fingers between hyoid and throid. Mallampati Obstructions Neck mobility
Features of Mallampati 1
Soft palate, uvula, anterior/posterior tonsilar pillars visible
Features of Mallapati 2
Tonsillar pillars hidden by tongue
Features of Mallampati 3
Only the base of the uvula can be seen
Features of Mallampati 4
Uvula can not be seen
What are the HEAVEN criteria ?
Hypoxemia SPO2 less than 93% Extremes of size Under 8 yro and clinical obesity Anatomic challenges Trauma, mass, swelling, foreign bodies or other structucal issues Vomit/blood/fluid Fluid in the pharynx or hypopharynx Exsanguination/anemia Anemia that can accelerate the rate of decompensation Neck mobility issues
What are the benifits of ramping ?
Improved upper airway patency
Decreased work of breathing
Prolonged safe apnea period
Sellicks maneruver is ….
Posterior pressure on the cricoid cartilage, believed to occulde oesphargus
May distort view of the airway and is no longer routinely recommended
BURP is ….
Backward Upward Rightward Pressure
Pressure maintained through completion of intubation
May also distort view
External Laryngeal manipulation is …
Provider performing laryngoscopy brings cords into view, then assistant maintains positioning
Current standard of practice if airway manipulation is needed.
List of intubation equipment 6 items
Macintosh blade Miller blade Video laryngoscope Boudie/introducer Supraglottic devices High flow nasal cannula
Bougie/introducer sizes for adults and paeds
Adults = 15 fr Paedatric = 10 fr
