Airway#2

Question 0

Eft cuff pressure should be no more than what amount? What risk is posed w/ high cuff pressures?

Answer 0

25 mmHg

Mucosal ischemia

Question 1

Combitube cuff pressure

Answer 1

Distal / esophageal: 12-20 ml

Proximal: 85-140 ml

Question 2

Men vs women ETT depth in cm

Answer 2

Men: 23 cm at teeth
Women: 21 cm at teeth

Question 3

Tube sizes for pre-term & term new borns

Answer 3

Preterm: 3.0
Term: 3.5

Question 4

ETT diameter (internal) calculation for pediatrics

Answer 4

(Age in years + 16) / 4

Question 5

Rational for us cuffed tubes and age recommendations for pediatrics

Answer 5

Prevents sub glottic stenosis and ulceration

Recommended in Children less than 8 years old

Question 6

Define aerophagia

Answer 6

Swallowing air while crying (pediatrics)

Question 7

CT ETT level

Answer 7

Tip of ETT at T2 to T3 or at level of lower edge of the medial aspect of the clavicle

Question 8

Pediatric needle cric considerations

Answer 8

Laryngeal prominence does not develop until late childhood. Take care to not damage cricoid cartilage (only circumferential structure to support larynx)

Question 9

Needle cric o2 goal

Answer 9

Short bursts high pressure source - 50 psi

Question 10

Succibylcholine & histamine consideration

Answer 10

Release if histamine w/ Succ administration, increases risk of Bronchospasm… Vasodilation?
Vec & Roc = no histamine release

Question 11

Critical blood gas levels

Answer 11

PH less than 7.2
PaCO2 greater than 55
PaO2: less than 60

Question 12

Asthma chest film findings

Answer 12

• Hyperinflated lungs: diaphragm relatively flat, costalphrenic angles are blunt / squared off, very dark fields (hypo dense) / not as many lung markings, costals visible on posterior side.
• Heart is normal sized (pushed a little more mid-line / appears thinner / over inflation of lung is pushing in on heart)
• Also found w/ asthma, COPD, air trapping of any kind.

Question 13

Dead space ventilation vs Venous Admixture

Answer 13

V=Q (1)
DeadSpace: air reaches poorly perfused alveoli
-V>Q (>1)
-PaO2 decreases, PaCO2 increases (ETCO2 decreases?)

Venous Admixture: blood passes through poorly ventilated alveoli. Venous blood mixes w/ arterial.

• V<1)
• PaO2 decreases, normal or low PaCO2

Question 14

Pneumonia: consolidation of what?

Antibiotic should be received within:

Answer 14

Consolidation of proteins, inflammatory factors

Antibiotics within 4 hours.

Question 15

CHF Chest Film Characteristics

Answer 15

• Hypertrophic heart
• R&L sides of heart have shaggy borders (pulmonary tree filled w/ fluid & expanding)
• Cobweb or white lines moving across lungs (Curly A & B lines, vessels engorged w/ fluid, basilar to apex distrubution)

Question 16

ARDS Chest Film

Answer 16

• Cobweb appearance but does not have clear lines as w/ CHF (described as patchy or diffuse)
• hypodense areas (black areas in 1 or both lungs where aeration is taking place. Typically in middle off main bronchi, not in apexes (as w/ CHF)