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FPC > Advanced Airway Principles > Flashcards

Advanced Airway Principles Flashcards

1
Q

Intubation Indications

A

Unable to swallow
cannot ventilate/oxygenate (failed airway algorithm)
GCS <8
Expected clinical course (inhal. burns, circum. burns, anaphylaxis)
Apnea
Airway obstruction
Respiratory Failure

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2
Q

In respiratory failure, only one value needs to be off to indicate the need to intubate. These values include:

A

pH, CO2, PaO2

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3
Q

LEMON pneumonic

A 
Look
Evaluate 3-3-2
Mallampati (I-IV)
Obstructions
Neck Mobility
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4
Q

3-3-2 rule

A

3 fingers in mouth
3 fingers btw jaw and hyoid
2 fingers between hyoid and thyroid

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5
Q

Airway Grading

A

Mallampati

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6
Q

Mallampati I

A

soft palate
uvula
anterior/posterior tonsillar pillars visible

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7
Q

Patients with a tall, thin neck are usually graded Mallampati

A

I

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8
Q

Difficulty level of Mallampati I

A

none

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9
Q

Mallampati II

A

Tonsillar pillars hidden by tongue

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10
Q

Difficulty level of Mallampati II

A

none

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11
Q

Mallampati III

A

Only base of uvula seen

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12
Q

Difficulty level of Mallampati III

A

Moderate

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13
Q

Mallampati IV

A

Uvula cannot be seen

Short, fat or muscular neck

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14
Q

Difficulty level of Mallampati IV

A

Severe

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15
Q

Curved blade that lifts vallecula

A

Macintosh

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16
Q

Straight blade that lifts the epiglottis

A

Miller

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17
Q

Direct downward pressure on the thyroid cartilage occluding esophagus and preventing aspiration during intubation:

A

Sellick’s Maneuver

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18
Q

Do NOT release Sellick’s Maneuver or BURP until intubation is

A

complete

19
Q

BURP pneumonic

A

Backward
Upward
Rightward
Pressure

20
Q

FAILED AIRWAY ALGORITHM

A

Patient requires secured airway
3 attempts of direct laryngoscopy unsucc.
Ventilate by BVM/simple airway/blind airway
Unable to ventilate/oxygenate SaO2 >90%
Cricothyroidotomy indicated (Cric)

21
Q

Gold standard of placement confirmation

A

Chest X-ray

22
Q

Distal tip of ETT should be

A

2-3 cm above carina or
1” above carina or
level of T2 or T3 vertebrae

23
Q

2nd most reliable confirmation method

A

visualization of tube passing thru cords

24
Q

When inflating the distal cuff on an ETT, the pressure should be between

A

20-30 mmHg to prevent mucosal tissue damage (only use amt required to make good seal)

25
Q

Consider saline instead of air in ETT

A

cuff

26
Q

Tube check

A

Bulb placed over ETT after intubation to confirm placement

27
Q

End tidal CO2

A

Measurement of CO2 in expired air; confirms ETT placement in trachea

28
Q

Colimetric Device

A

one-time device that changes colors when CO2 passes through it

29
Q

CapnoCheck

A

reusable ETCO2 device that both ETCO2 and RR (aka EMMA Emergency Capnometer)

30
Q

Capnography

A

measures EtCO2, waveform

31
Q

7 P’s pneumonic

A 
Preparation
Preoxygenate
Pretreatment
Paralysis with induction
Protect and position
Placement with proof
Post intubation management
32
Q

Preparation

A

Make sure equipment is serviceable

33
Q

Preoxygenate

A

3-5 minutes, 10-15 LPM if possible

34
Q

Pretreatment

A

LOAD

35
Q

Paralysis with induction

A

Neuromuscular blockade (NMB), induction agent, and pain control

36
Q

Protect and position

A

sniffing position

towel under patient’s shoulder blades

37
Q

Placement with proof

A

tube passing through cords
CXR
Capnography

38
Q

Post intubation management

A

Maintain sedation, oxygenation

39
Q

LOAD pneumonic (RSI pretreatment)

A

Lidocaine (head/lung injury)
Opiates
Atropine for infants
Defasciculating dose

40
Q

(LOAD) Lidocaine

A

blunts cough reflex preventing ICP increases (head/lung injury)

41
Q

(LOAD) Opiates

A

blunts pain response

42
Q

(LOAD) Atropine

A

prevents reflexive bradycardis in infants < 1 y/o (0.02 mg/kg)

43
Q

(LOAD) Defasiculating Dose

A

Succinylcholine
Rocuronium
Vecuronium

FPC (17 decks)

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