Airway Flashcards
Critical values
Ph< 7.2, CO2>55, and PAO2 <60
LEMON
Look, evaluate (3,3,2), Mallampati, Obstructions, Neck Mobility
Mallampati 2
Tonsillitis pillars hidden by tongue
Mallampati 3
Only base of uvula can be seen
Mallampati 4
Uvula cannot be seen
HEAVEN
Hypoxemia = 93% at time of laryngoscope
Extreme size: less than 8yo or obese
Anatomic challenges
Vomit, blood, fluid
Exsanguination/anemia
Neck mobility
Ramping
Ear to sternal notch
Sellicks maneuver
Posterior pressure on cricoid cartilage, no longer recommended.
(Choke time sellick who doesn’t work anymore)
BURP
Backward, upward, rightward pressure
External laryngeal manipulation
Provider brings cords into view and then airway assistant maintained positioning
Mac blade
Lifts epiglottis via the vallecula
Miller
Direct displacement of epiglottis
Neonates, infants
Bougie
Adults 15 fr
Pediatrics 10 fr
High flow nasal cannula
20-60 liters per min
Ett cuff pressure
20-30 mmhg
(25 is standard)
Standard of placement
Chest X-ray, 4-5 cm above carina
T3-t4
End tidal CO2
Inhalation ⬇️ expiration ⬆️ expiratory plateau ➡️ ETCO2
Colorimetric device
Yellow is yea, purple is pull
RSI 7ps
Prep
Preoxygenate
Pretreatment
Paralysis with induction
Protect and position
Placement with proof
Post intubation management