Airway Flashcards
assess the airway to ensure it is
patent
protected
functional
describes the anatomic pathway air must travel to reach the lungs
patancy
Failures of patency may be related to
- trauma
- allergy / angioedema
- anything impeding a clear trajectory for air to travel
Failures of airway protection are often related to
higher order diseases that subsequently affect the patient’s mental status
ex. intracranial bleeding, seizures, or shock
A first effort to improve airway patency should always be
re-positioning of the head and jaw in an attempt to relieve posterior airway obstruction
This maneuver would be the favored airway technique in a patient who has any suspicion of cervical spine injury.
Jaw Thrust
_____________ pulls the tongue forward and maintains the tongue position away from the posterior pharynx
oropharyngeal airway
unconscious patients
The nasopharyngeal airway is contraindicated when
in patients with facial trauma involving the nose or central face.
What is rapid sequence intubation
combines the rapid administration of a sedative agent followed by a paralytic agent for a quick and controlled intubation
First step of rapid sequence intubation (after equipment set up)
pre-oxygenated ASAP with non-rebreather mask with 15 L/min of oxygen flowing
nasal oxygen should continue throughout the intubation.
Pre-treatment medications, (given 3 minutes prior to intubation) examples
atropine to infants –> blunt vagal stimulation
lidocaine for intracranial hemorrhage –> blunt any ↑ intracranial pressure.
Commonly used sedatives in intubation
- Ketamine- ↑ BP, slowest onset
- Propofol- ↓ BP
- Etomidate - no BP change, fastest
_________ is the most common depolarizing neuromuscular blocker used in RSI
Succinylcholine
due to its rapid onset and short duration of action
Commonly used paralytics in intubation
- Rocuronium- lasts ~50 min
- Succinylcholine- hyperkalemia
tilting the head back and extending the cervical spine
sniffing position
Video laryngoscopy is different from direct intubation in this way
in VL, the patient’s head can remain in the neutral position and the blade is passed directly over the tongue as opposed to the side.
Confirm placement of endotracheal tube
end tidal CO2 detection
auscultation with insufflations of the bag-valve mask
chest x-ray confirmation
Intubated patients are commonly sedated with continuous infusions of ?
benzodiazepines
opiates
Myxedema coma
life- threatening complication of hypothyroidism.
classic s/s lethargy/coma hypothermia bradycardia periorbital and nonpitting edema delayed relaxation phase of DTRs (areflexia in more severe cases).
triggered by sepsis, trauma, surgery, chf , prolonged cold exposure, or use of sedatives or narcotics
Very first step of seizure management
Pt placed in a lateral decubitus position to prevent aspiration of gastric contents
