Airway Devices and Mgmt Flashcards
upper airway obstructions
food vomitus blood clots enlargement of tissue pressue on the walls of the airway altered LOC loss of tone (pharyngeal muscles, tongue)
mgmt of upper airway obstruction
inspect
palpate
auscultate
name the advance airway devices
oral airway nasal airway laryngeal mask airway (LMA) tracheostomy endotracheal tube (ETT)
are oral airways seen often in the ICU?
yes
what do oral airways contain?
bite blocks
what state must the pt be kept in for this to be used and why?
pt must be kept unconsconscious bc it hits their gag reflex
is a nasal airway sen often in the ICU and why?
yes bc many pts do not have the energy to manage their own nasal secretions
is a laryngeal mask airway seen often in an ICU and why?
NO- never
blocks the esophagus
temporary
used by ambulances and anesthesiologists
who can insert an ETT?
skilled professionals- MD, Resp Therapists, anesthesiologists
can we insert an ETT?
no- but we can assist
where must an ETT be placed
2 cm above chorinus
how do you know the ETT has been placed in the correct position?
chest x ray and bilateral breath sounds
how do you know if the ETT was placed too far down and what is this also known as?
you will hear breath sounds only on one side
aka main stem intubation
The _____ lung is easier bc it is a straight shoot as compared to the ______ lung bc it is curved
right
left
what will you see if the ETT has been placed in the esophagus?
the stomach will expand and you will not hear breath sounds
what part of the ETT must be checked before intubation?
the cuff
what is the End Title CO2 and what does it do
- at the end of expiration, it is placed on top of ETT
- pushes air in
- when air comes back, it is tested for CO2
- CO2 will test purple if it CO2, green if stomach acid
what part of the ETT allows you to monitor for placement?
lip line
what is the purpose of an ETT ?
- provide a patent airway for mechanical ventilation
- removal of secretions
how is an ETT inserted
with the help of a laryngoscope
what are some advantages of advanced airway devices
provides patent airway mechanical ventilation suctioning secretions decr work of breathing improve oxygenation
name the disadvantages of advanced airway devices
discomfort cough and swallowing reflex are depressed secretions become thicker incr risk of aspiratiom VAP ulceration stricture inability to verbally communicate inadvertent removal use of restraints
how long can you use an ETT for ?
10 days at most
what are some advantages to using a tracheostomy?
bypasses the upper airway allows removal of secretions permits long term mechanical vent prevents aspiration of secretions replaced ETT can be temporary or permanent ventilation can be well controlled
