airway Flashcards
List inspection/observation airway assessments
- observe the pt’s overall appearance: alert and orientated, active/hyperactive/drowsy
- colour (central and peripherally): pink, mottled, cyanosed
- respiratory effort (WOB): mild, mod, severe
- use of accessory muscles
- symmetry and shape of chest
- audible sounds: vocalisation, wheeze, stridor, grunt, cough
Identify auscultation airway assessments
- listen for absence/equality of breath sounds
- auscultate lung fields for bilateral adventitious noises e.g. wheeze, crackles etc.
Identify palpation airway assessments
- bilateral symmetry of chest expansion
- skin condition - temp, turgor and moisture
- capillary refill
- subcutaneous emphysema - air is trapped under skin and can spread
What do we do with airway obstructions?
- identify and remove any partial or complete airway obstruction
- position airway to maintain latency
- insert oropharyngeal or nasopharyngeal airway
- protect C-spine
Define airway obstruction.
A blockage in the airway. May partially or totally prevent air from getting into your lungs.
Identify types of airway obstruction
- upper airway obstruction
- lower airway obstruction
- partial airway obstruction
- complete airway obstruction
- acute airway obstruction
- chronic airway obstruction
Identify causes of airway obstruction
- foreign body
- infection (e.g. epiglottis - causes swelling, tetanus causes lockjaw)
- tongue obstruction
- anaphylaxis
- tumor
- trauma
- poison and toxic exposure
Identify signs and symptoms of a life threatening airway
- dyspnoea, laboured respirations
- decreased or no air movement
- cyanosis
- presence of foreign body in the airway
- face or neck trauma
- breathlessness/agitation/combativeness
- unconscious
Identify basics for how to establish an airway
- first method: correct head position
- head tilt/chin lift or jaw thrust
- remove any foreign objects
- suction
- insert an airway
- endotracheal intubation
- needle or surgical airway
Identify indication for airway management
- apnea
- obstruction
- GCS - drop in GCS by 2 needs to be assessed
- unstable midface trauma
- airway injuries
What is an oropharyngeal/nasopharyngeal airway used for
Designed to overcome soft palate obstruction
- Guedel/nasopharyngeal
When are NPA and OPA contraindicated?
NPA: nasal/cranial trauma, base of skull fracture
OPA: conscious patient, patient has intact gag reflex/cough
What are laryngeal mask airways used for?
Short cases of airway management - surgery, resuscitation
Identify disadvantages of LMAs
- only short-term
- high airway pressure/poor lung compliance = risk of a significant leak around the cuff causing hypoventilation
- insertion can cause coughing, straining
Identify indications for endotracheal intubation
- for airway protection - upper airway obstruction
- protect and maintain airway in patients with decreased GCS
- facilitates mechanical ventilation
- enable tracheal suctioning and removal of secretions
