Airway care Flashcards
What is the most serious complication with an oral airway.
Laryngospasm
What is epitaxis mean
Nasal bleeding
What is a contraindication to head tilt/chin lift
Suspect neck fracture
Why would you choose a nasopharyngeal airway instead of a oralpharyngeal airway?
The patient is conscious and has no other contraindications
If you were alone, how long would you do CPR before you activate the EMS system?
2 minutes
Why should you not use excessive high flows with manual resuscitation bags?
It may cause one of the valves to jam
What is the pressure relief valve set at on a pneumatically powered resuscitation device?
50 cm H2O
What are the five indications to intubate someone?
Provide a patent airway
Access for suctioning.
Mechanical ventilation
Protect the airway
For medication delivery when IV access is unavailable
What are the different drugs you can deliver through an endotracheal tube and what is the process?
Valium-sedative
Atropine-bradycardia
Narcan-narcotic overdose
epinephrine-asystole
Double the normal dose and squirted down the endocrine tube with 10 cc of saline. Hyperventilate for 30 seconds.
With serious Laryngospasm that can happen with an oral airway or intubation, what is the treatment?
Tracheostomy
How do you tell immediately if there is a right mainstem intubation
If the endotracheal tube is greater than 25 cm at the lip or the NTT is >29 cm at the nare
What is the neuromuscular agent you would recommend for intubation?
Succinylcholine
What should you do for intubation if the larynx isn’t in an interior location or the patient is at risk of aspiration
Apply cricoid pressure (Sellick maneuver)
What are the four priority assessments for determining proper endotracheal tube position??
- Inspection, look for chest expansion and proper placement of the tube(ET=<25, NT=<29)
- Oscillation-bilateral breath sounds
- Capnography, or CO2 detection-should turn yellow
- Chest x-ray showing tube 2 to 6 cm above carina
What type of special purpose airway is designed to prevent VAP
Continuous aspiration of subglottic secretion (CASS) tube
With a CASS tube, what is the continuous suction line set at?
20 mm Hg
What type of airway would you recommend for treatment of a bronchopleural fistula, or independent lung ventilation
Double lumen endotracheal tube, also known as a DLT, Carlen’s Tube, or Endobronchial tube
High-pressure assisted ventilation with supraglottic airways has been shown to cause what side effect?
Gastric insufflation
What type of supraglottic airway is designed for esophageal intubation
King LT supraglottic airway
What are two types of endotracheal tube exchangers And which one allows for oxygenation and ventilation
- Airway exchange catheter allows for oxygenation and ventilation
- Gum elastic bougie
What is the test called when you evaluate the amount of leakage around the tube during positive pressure ventilation with the cuff deflated
Qualitative leak test
What should you prescribe to treat moderate distress/stridor after extubation
Oxygen, cool aerosol, racemic epinephrine, and Heliox therapy
Besides varying respiratory distress levels, what are some other postextubation complications?
Vocal cord polyps
Mucosal ulceration
Tracheomalacia
Tracheostenosis
What is a late complication of a tracheostomy tube insertion?
Tracheo-Esophageal (T-E fistula)
Obstruction, hemorrhage, infection
What are two common hazards of suctioning someone’s airway?
The most severe is Hypoxemia leading to tachycardia and arrhythmias
Bradycardia from vagus nerve stimulation
What does iatrogenic mean?
Caused by the procedure
What is normal vacuum pressure for an adult suctioning?
120-150 mm Hg
How long is the ideal catheter for suctioning their way?
20 to 22 inches
How do you calculate French size for suctioning?
Use 1/2 the diameter of the tracheal tube size and multiplied by three
When using a Luken trap, what do you flush the catheter with tube obtain your sample
Sterile water, or isotonic saline
Why would you change to a close system suction catheter for suctioning?
If the patient has an infection, is on peep therapy, or desaturates during suctioning
If the patient has an adverse reaction to suctioning, what would be your next steps?
Reduce the level of vacuum and suction time
