Airway Flashcards
ET TUBE:
_____ female most common size.
_____ for obese.
7.0
7.5
ET TUBE:
_____ male most common size.
_____ for obese.
8.0
8.5
ET TUBE:
ET Tube size depth measured by tube size X _____ at the teeth.
3cm
ET TUBE:
_____ placement should result in equal chest rise.
Trachea
ET TUBE:
If tube mark is too far its in the ____.
Right mainstem
ET TUBE:
If tube mark is too short its in the _____.
Esophagus
ET TUBE:
Secure ET tube to keep it from coming dislodged. Most effective securing devise is a _____ device.
Commercial
Select Best OPA:
If too short, creates _____ obstruction.
Tongue
Select Best OPA
If too long, creates _____ obstruction.
Epiglottis
If choking - confirm choking then _____ or _____.
Back blows or Heimlich chest thrusts.
While choking…..
Goes unconscious - then begin _____.
CPR
Respiratory distress - complaining of _____.
Shortness of Breath (SOB)
Respiratory failure - _____ and/or _____
Altered LOC and/or Unresponsive
Adequate vs Non Adequate Breathing
_____ - good rise & fall, breathing 12-20 times/min, SPO2 100%
_____ - no rise and fall of chest, unable to talk
Adequate
Inadequate
Initial CPAP setting:
5-10 cm of H20
_____: making sure air is moving in and out; listening for inappropriate noises (Strider, Wheezing, Rales, etc)
Listening to Lung Sounds
STEPS FOR DEEP SUCTION
Suction on the way in or out?
Max _____ seconds.
Usually measured from _____ to _____.
Suction on the way out.
10-15 seconds.
Lips to Earlobes.
3 Rules for when to actually intubate:
Cardiac Arrest
Cardiac failure with no gag reflex
Inadequate rise and fall
Airway Interventions:
_____- 2 cuffs and 1 pilot balloon
King Tube
Airway Interventions:
_____/_____-1 cuff and 1 pilot balloon
LMA Tube/ET Tube
Airway Interventions:
_____- 2 cuffs and 2 pilot balloons.
Combi
_____ / _____ is a technique that has become part of a rapid sequence intubation to prevent aspiration of gastric contents.
Cricoid pressure/Selick Maneuver
_____/_____ is used to help align the airway structures during endotracheal intubation.
Sellick Maneuver
_____: Moving chin and forehead.
Head Tilt Chin Lift
_____: index finger at jaw to push forward and tilt the head back.
Modified Jaw Thrust (for c spine concerns)
What does clear fluid in Pt’s mouth possibly indicate?
A possible basal fracture where CSF is leaking out.
Check for adequate breathing with _____, _____ and _____.
Look, listen and feel
Breath Sounds:
_____ - short and explosive, bubbling or drinking. Located typically lower but can be high. Happens during inhalation.
Rales (crackling)
_____: low pitched wheezing while breathing out, rubbing.
Rhonchi
_____: harsh, squeaking with every breath. (Blocked upper airway)
Stridor
Normal Range for ETCO2:
35-45
_____: High pitched whistling (lower airway)
Wheezing
_____: gasp followed by long bout of coughing.
Whooping
What is the best way to secure a tube?
Commercial/manufacture device that has integral bite block.
Regarding Airway in a Stroke Patient:
What’s the first option for airway?
See if they can maintain their own airway.
Regarding Airway in a Stroke Patient:
If gag reflex is present then _____.
Bag
Regarding Airway in Stroke Patient:
If no gag reflex then _____.
RSI (rapid sequence intubation)
_____: Breathing too fast.
Hyperventilation
_____: Breathing too slow.
Hypoventilation
How far do you enter?
All the way.
Patient appears to be choking but coughing =
Partial obstruction
Patient appears to be choking and not coughing =
Full obstruction
In complete airway obstruction what are the three steps?
Use forceps to reach and grab.
Use ET tube to shove the object down.
Do CPR
When intubating patient nasally, what 3 things to consider?
Patient can be awake/conscious
Patient must be able to breathe on their own
Medic times breathing with pushing ET Tube.
If SPO2 is rising the patient is _____.
Improving
Blood flow through the heart: (9)
VC
RA
RV
PA
L-H
PV
LA
LV
AA-B
In the Vena Cava to the
Right Atrium to the
Right Ventricle to the
Pulmonary artery to the
Lungs to the heart via the
Pulmonary veins into the
Left atrium to the
Left ventricle to the
Aortic artery to the body.
What type of catheter is used to suction someone’s mouth?
Rigid/Hard
What type of catheter is used for suctioning a tube (ET Tube, King Tube, Etc)?
Soft
Normal Capno:
35-45 mmHG
Right mainstem is at a _____ degree while the left mainstem is at a _____ degree.
40 degree angle
60 degree angle
Capnography:
Shark fin indicates _____.
Bronchospasms
Capnography:
SpongeBob shape or square then there is _____ ventilation.
Good
Average tidal volume = breath per minute X _____.
Breath per minute x volume.
Average air in and out in 1 minute = _____.
Minute volume
Minute Volume Formula:
Minute Volume = _____ x _____
Rate x Depth
Green/yellow mucus signifies _____.
Pneumonia
_____ are the highest priority in SOB because you need to find out what is causing it.
Lung Sounds
What do es PEEP stand for?
Positive-End Expiratory Pressure
What does PEEP do?
Improves oxygen saturation by accumulation of air and increases alveolar pressure at the end of expiration.
Why do we confirm breath sounds when intubating?
To ensure we did not tube the stomach.
COPD signs and symptoms: (4)
Fatigue, blueness of lips/fingernails, wheezing, SOB
Chronic Bronchitis sings and symptoms: (3)
Cough, wheezing, mucus. Aka smoker’s cough
Etomidate has a small or large effect on BP.
Small
_____: too much air in the lungs.
Hyperresonance
_____: fluid in the lungs.
Hypo-resonance
Managing a stroke patient airway, check their gag reflex and then _____.
Bag.
Gag and bag
How to measure for rigid catheter?
Earlobe to mouth
What do you use to check for bi lateral rise and fall?
Positive Pressure Ventilation (PPV)
Hypoventilating patient will allow _____ to build up in the body, which causes then to become _____.
CO2
Acidotic
Hyperventilating a patient will get rid of _____ and cause patient to become _____.
CO2
Light headed/alkalotic
Are you allowed to assist with a bronchodilator while off duty?
Yes
The following describes what?
Mask with one way side port, an attached reservoir bag to hold oxygen ready to inhale.
Non-Rebreather
_____ is indicated for low-to-moderate oxygen requirements and long-term oxygen therapy.
Nasal Canual
Upper or Lower Airway sounds:
Gurgling, snoring, Stridor.
Upper
Upper or Lower Airway Sounds:
Rails, rhonchi, wheezing.
Lower
When intubating a patient you notice distention of the abdomen and absent lung sounds. What does this mean?
You intubated the esophagus. Bad job.
When intubating a patient you notice equal rise and fall of the chest and confirmed ETCO2. What does this mean?
You intubated the trachea. Good job.
Treatment for asthma:
Bronchodilator (albuterol), fluids, steroids.
How do you measure for an OPA?
Measure from the mouth to the angle of the jaw.
When managing an unconscious patient with an airway block, you should worry about _____ and need _____.
Aspiration
95-100%
ET tube is considered to be the golden standard and _____ to confirm intubation.
CO2
Stoma - We can connect _____ and may/may not suction like ET tube soft suction goes in until it reaches the _____ or meet resistance then suction ___-___ seconds on the way out.
BVM
May suction like ET tube
Carina
10-15 seconds
What increases and decreases CO2 levels in the body?
Quality of breathing and rate of breathing.
What is the first priority of ABC’s?
Airway
How do you clean the catheter after it is used?
Wipe it with sterile cloth or wash with sterile water.
What devices need to be lubed before use?
ETT, KING, LMA, NPA COMBI.
What complications in the airway may cause difficulty in bagging?
Burns
Drowning in person will be bagged slower/faster to help displace water?
Slower
O2 flow rate for BVM needs to be high enough to what?
Keep reservoir bag inflated.
Flow rate for non-rebreather:
10-15 lpm
Preferred method for caring for distended stomach is _____:
Nasogastric tube placement
When to use head tilt chin lift over modified jaw thrust?
Suspected c spine injuries
Room air is _____ oxygen and _____ carbon dioxide.
21% O2
.04% CO2
Pressure is _____ mm of mercury at sea level or _____ psi.
670 mm mercury
14.7 psi
Macintosh Blade vs Miller Blade:
_____ on the vallecula.
_____ on the epiglottis
Mac
Miller
The _____ breath sounds over the trachea has a higher pitch, louder, inspiration and expiration are equal and there is a pause between inspiration and expiration.
Bronchial breath sounds
The _____ breathing is heard over the thorax, lower pitched and softer than bronchial breathing.
Vesicular breathing
When the tube is too deep, it will most likely go into the _____.
Right main stem
_____ ml flow bag on non-rebreather never deflates more than _____ when breathing.
12-15 ml
1/3
When using a dual lumen (Combi tube) airway on an unresponsive patient, the patient must be ___-___ tall and no gag reflex.
4’9” - 6’7”
_____: a below normal level of oxygen in the blood, specifically in the arteries.
Hypoxemia
_____ is the sensation of breathlessness in the recumbent position, relieved by sitting or standing.
Orthopnea
_____ is a sensation of shortness of breath that awakens the patient, often after 1-2 hours of sleep, and is usually relieved in the upright position.
Paroxysmal Nocturnal Dyspnea (PND)
_____: the mechanical movement of air in and out.
Ventilation
_____ is physiologic and involves the exchange of gases in the alveoli and in the cells.
Respiration
_____ respirations are a rare abnormal breathing pattern that can occur while awake but usually occurs during sleep. The pattern involves a period of fast, shallow breathing and moments without any breath at all, called apneas.
Cheyne-Stokes
_____: inflammation of the bronchioles. Virus. Affects larger airways… bronchi)
Broncholitis
_____: inflammation of the mucous membrane in the bronchial tubes. It typically causes bronchospasms and coughing. Bacterial. Affects small airways… bronchioles
Bronchitis
Part of the brain that controls breathing:
Medulla oblangata
CPAP must be done before _____.
Respiratory Failure
3 Levels of Respiratory problems in order from least to worst:
Distress
Failure
Arrest
