airway care Flashcards

1
Q

Epistaxis

A

nasal bleeding

change every 24 hours

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2
Q

Allows for establishing patent airway in patients with suspected neck fracture.

A

jaw thrust/ modified jaw thrust

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3
Q

treatment for mild airway obstruction

A

encourage the pt. to continue spontaneous coaughing and breathing efforts

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4
Q

manual resuscitation bag

reservoir provides

A

provides 95-100% oxygen (15l/min)

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5
Q

manual resuscitation bag

where is the PEEP valve attached

A

expiratory side of patient valve

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6
Q

manual resuscitation bag

Check inlet valve if …

A

if bag fills rapidly and collapses easily with minimal pressure

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7
Q

manual resuscitation bag

if bag becomes difficult to copress and patient compliance is NORMAL

troubleshot

A

patient valve may be stuck, open or closed

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8
Q

Flow inflating resuscitation Bag is used for

A

manual resucitation of neonates

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9
Q

Flow inflating resuscitation Bag

Peak insp. pressure is controlled by

A
  • Flow to bag
  • Adjustment of flow control valve
  • How hard the bag is squeezed
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10
Q

Flow inflating resuscitation Bag requires

A

compressed gas source to operate

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11
Q

Flow inflating resuscitation Bag is also called

A

Flow inflating Anesthesia Bag

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12
Q

Flow inflating resuscitation Bag should be kept…

A

half full between breaths

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13
Q

Flow inflating bag will not inflate in the presence of

A

leaks
low flow to bag
opened flow control valve
open pop-off valve

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14
Q

NAVEL
stands for…

A

Narcan
Atropine
Valium/ Verse
Epi
Lidocaine

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15
Q

medication

give ___ for narcotic oversoe

A

Narcan

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16
Q

medication

Give ___ for bradycardia

A

Atropine

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17
Q

medication

Sedative

A

Valium/ Verse

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18
Q

medication

Use Epinephrine during

A

Aystole

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19
Q

What do you do when administering medication through the ETT

A
  • double the normal IV dose
  • Flush with 10mL of saline
  • hyperventilate for 30 sec
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20
Q

Cuff pressure is directly related to

A

capillary pressures

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21
Q

Cuff pressure (mmHg)

A

20 -25 mmHg

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22
Q

Cuff pressure (cmH2O)

A

25-35 cm h2o

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23
Q

Most serious complication of intubation

A

Laryngospasm

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24
Q

Succinylcholine is a

A

neuromuscula blocking agent

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25
Q

is indicated if the larynx is in an anterior location or pt is at risk of aspiration

A

Sellick maneuver
(Cricoid pressure)

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26
Q

Blade that fits into valecular

A

Macintosh

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27
Q

Blade that directly raises epiglottis

A

Macintosh

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28
Q

blade that fits directly UNDER the epiglottis

A

Miller

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29
Q

Blade size for adult
Blade size for pediatric
Blade size for term infant
blade size for pre-term infant

A

size 3
size 2
size1
size 0

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30
Q

ET Tube size for
Adult Males

A

8.0-8.5 mm

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31
Q

ET Tube size for
Adult Females

A

7.0-7.5mm

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32
Q

ET tube size for Pre-term infants

A

2.5-3.0 mm

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33
Q

ET tube size for Full-term infant

A

3.0-3.5

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34
Q

Tube distance marking

oral intubation

A

21-25 cm mark at pt’s lips

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35
Q

Tube distance markings

nasal intubation

A

26-29cm marked at patient nare

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36
Q

oral ETT inserted >25cm

what do you recommend?

A

right mainstem bronchus intubation
withdrawal of endotracheal tube to proper position 21-25cm at lips

37
Q

Tubes to prevent VAP

A

(CASS) continous aspiration of subglottic secretions tube

38
Q

explain CASS

continous aspiration secretions tubes

A

Continuous suction is provided via separate tube connected to a cacuum pressure of 20mmHg

39
Q

Double-lumen ET tube is also called

A
  • Edobronchial tube
  • Carlen’s tube
40
Q

how do you confirm a Double-lumen ET tube placement

A

the cuff has a radiopaque line that confirms placement

41
Q

Double-lumen ET tube has two cuffs..

A
  • one cuff is a low pressure, high volume cuff
  • The other cuff is smaller and a high pressure, low volume cuff
42
Q

indications for Double-lumen ET tube

A
  • Unilateral lung diseases ventilation
  • Independent lung ventilation
  • Bronchopleural fistula
  • privide airway protection to the unaffected lung
43
Q

example of a supraglottic airway

A

Laryngeal Mask airway (LMA)

44
Q

Laryngeal Mask airway (LMA) is positioned …

A

directly over opening into the trachea (hypopharynx)

45
Q

Contraindication of Laryngeal Mask airway (LMA)

A

risk of aspiration

46
Q

indicated for short term ventilation and when intubation is not possible by the oral or nasal route

A

Laryngeal Mask airway (LMA)

47
Q

Small diameter semi-flexible tube

Acts as a sylet

A

Gum elastic bougie

48
Q

difference between Airway exchange catheter and Gum Elastic Bougie

A

AEC allows oxygenation and ventilation GEB does not

49
Q

Another term for stridor

A

Laryngeal edema

50
Q

Severe respiratory distress and /or Marked inspiratory stridor

Management

A

Reintubate

51
Q

Mod distress/ stridor

management

A
  • oxygen
  • cool mist aerosol
  • racemic epinephrine
  • heliox therapy
52
Q

Mild distress/stridor
Sore throat

A
  • provide humidity, oxygen and/ or racemic epi as necessary
53
Q

Other post-extubation complications

caused by chronic inflammation

A

vocal cord polyps

54
Q

Other post-extubation complications

torn mucosa, does not require reintubation

A

Mucosal ulceration

55
Q

Other post-extubation complications

softening or dilation of tracheal carilage

A

Tracheomalacia

56
Q

Other post-extubation complications

gradual obstruction (narrowing) that occurs with healing causing stridor

A

Tracheostenosis

57
Q

RT’s role in Tracheostomy procedure

A
  1. maintain airway, provide ventilation,
  2. stabilize trache tube
58
Q

Trach cuff sould be inflated whenever:

A
  • pt is eating
  • pt is on positive pressure ventilation
59
Q

Trach should be changed if

A
  • Tube is obstructed
  • Tube too small
  • Punctured cuff
60
Q

clean stoma with…

A

hydrogen peroxide

61
Q

What can you apply to a stoma

A

sterile dressing and/or antibiotics

62
Q

Trach tube

Have opening in outer cannula above the cuff

A

Fenestrated tubes

63
Q

Fenestrated tube allows

A

the pt to breath through upper airway and speak when the tube is plugged

deflate cuff and take out inner cannula

64
Q

Rigid platic tube about 1 inch in length that can be placed in stoma after trach tube is removed

A

Tracheal button

65
Q

tracheal speaking devices

describe

A

one way valve-that attaches to trach tube

66
Q

How does Tracheal speaking device work?

A

Inspiration: valve opens and air enters
Expiration: valve closes and air passes around cuff and thorugh vocal cords
Cuf must be deflated

67
Q

Laryngectomy

A

removal of the larynx
no longer any connection between the pt’s upper and lower resp tract

68
Q

Performed to treat upper airway carcinoma

A

Laryngectomy

69
Q

made of soft pliable material

A

Laryngectomy tubes

70
Q

Do Laryngectomy tubes had an inflatabel cuff?

A

No

71
Q

Vacume regulator pressure:
Adult

A

120-150 mmhg

72
Q

Vacume regulator pressure:
Child

A

100-120 mmhg

73
Q

Vacume regulator pressure:
Infant

A

80-100 mmhg

74
Q

a close system or inline suction catheter

name

A

Ballard

allosw ventialtion and oxygenation during suction

75
Q

ideal catheter length

A

20-22 inches

76
Q

oral suction device

name

A

Yankauer / Tonsil suction device

77
Q

catheter size equation

A

(ID/ 2) x3

78
Q

used to collect sputum speciment

A

Lukens trap / sterile suction trap

79
Q

how to place a Lukens trap

A

in the upright position between the suction catheter and the suction tubing

80
Q

Coudé tip catheter

use

A

angled to help suction the LEFT main stem bronchus

81
Q

Suction catheter should be in the airway no longer than

A

15 sec

82
Q

Extended Trach tube is recomended for

A

patients who are obese or use cervical collars

83
Q

Metal trach tube, comes with inner cannula

A

Jackson trach tube

not for resuscitation or positive pressure ventilation

84
Q

technique for inserting a nasopharangeal airway

A

same direction of its shape , without rotation

85
Q

technique to insert an oralpharangel airway

A

insert opposite of its anatomic shape (upside down) to back of throat and then rotate into the correct position (180 or 90 degrees)

86
Q

requires compressed gas source to operate

A

flow inflating resuscitation bag

87
Q

if ETT cuff needs more than 25mmhg pressure recommend ..

A

changing the tube o a larger one

88
Q

if unable to pass a suction catheter recommend

A

removing the tube, ventilate and insert a new tube