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Protocols > Airway Management > Flashcards

Airway Management Flashcards

1
Q

What type of PT HX should you get?

A

OPQRST/SAMPLE, previous HX airway compromise, trauma/dental surgeries, asthma/COPD/anaphylaxis

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2
Q

What are some S/S for the need of airway management?

A

SOB/abnormal rate/depth/effort, use of accessory muscles, wheezing, stridor, rales, rhonchi, hoarseness, pallor or cyanosis, AMS, hypoxemia/hyper or hypo-carbia

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3
Q

What are some possible differentials to keep in mind?

A

Head injury/stroke, drug OD or airway obstruction, pulmonary edema/ ARDS, cardiac arrest or inhalation injury, or COPD/asthma/anaphylaxis

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4
Q

What is ARDS?

A

Acute Respiratory Distress Syndrome

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5
Q

How do you open, assess, and clear the airway?

A

Head-tilt/chin-lift or modified jaw thrust, finger sweep, if obstructed, perform abdominal or chest thrusts five times and attempt to ventilate, and repeat until airway is clear

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6
Q

What are the guidelines for SL1?

A

General patient care, open assess, clear airway, suction, BVM ventilations, NPA/OPA, O2, and high flow nasal cannula

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7
Q

What is the rate for assisted ventilations on an adult?

A

<10 and >30 as needed

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8
Q

When do you not use an OPA?

A

pt is conscious or gag reflex intact

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9
Q

How much LPM NC do PTs get if SpO2 is <85%?

A

5-25 LPM

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10
Q

What are the guidlines for SL2 and SL3

A

Supraglottic airway, EtCO2, needle decompression, PEEP valve, CPAP, and suction

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11
Q

When do you use an EtCO2?

A

When a PT is lethargic, AMS, hypotensive or w/SGA

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12
Q

When do you do a needle decompression?

A

If tension Pneumothorax is suspected with EMT x/TCCC Tier 2 and OLMD approval for anterior or lateral placement

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13
Q

What is a PEEP valve?

A

positive end-expiratory pressure valve

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14
Q

What are the guidelines for SL4?

A

Open, access, clear airway, cricothyroidotomy, suction, EtCO2, and post-intubation sedation and pain control

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15
Q

What are the guidelines for SL2 and SL3

A

Supraglottic airway, EtCO2, needle decompression, PEEP valve, CPAP, and suction

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16
Q

What are the guidelines for SL2 and SL3

A

Supraglottic airway, EtCO2, needle decompression, PEEP valve, CPAP, and suction

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17
Q

What does SL3 do to open, access, and clear airway?

A

utilize Magill forceps as needed to remove obstruction

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18
Q

What do you do if SGA is not effective or patient requires ETT to allow for tracheal suctioning?

A

Video Laryngoscopy (w/wo Bougie) or Direct Laryngoscopy (w/wo Bougie)

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19
Q

When do you do the cricothyroidotomy?

A

emergency to secure an airway, unless require by PT condition, severe airway edema or edema/burns from smoke inhalation

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20
Q

What should you consider for suction?

A

Where the OG tube placement is after you advanced airway if gastric distention is present and if perform ETT suction

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21
Q

What is ETT?

A

Endotracheal tube

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22
Q

What do you do when you perform ETT suction PRN?

A

Inject 10mL NS into ETT/Cric prior to suction for thick secretions

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23
Q

What is the primary method for post-intubation sedation and pain control?

A

Ketamine 2mg/kg IV/1O/IN, and repeat q 10 - 15 min PRN to sedation control/nystagmus

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24
Q

What is PRN?

A

Pro re nata “when necessary” and/or as needed

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25
Q

What is the alternate method for post-intubation sedation and pain control?

A
  • Midazolam 2.5 - 5mg IV/IO/IN and repeat q 5 - 10 min PRN to max dose 10mg
  • Fentanyl 1mcg/kg IV/IO/IN (max single dose 100mcg) and repeat q 5 - 10 min PRN to 200mcg
26
Q

What do you do when a patient is on post-intubation sedation and pain control?

A

Must be placed on continuous cardiac, EtCO2 and SpO2 monitoring, document vitals/BP q 5 min for the first 15 min then q 15 min thereafter

27
Q

What are the primary types of supraglottic airways?

A

iGel and Ng tube

28
Q

What is an alternate form of a supraglottic airway?

A

King-LT/LTs-D

29
Q

What is a contingency form of supraglottic airway?

A

LMA

30
Q

What size and color is 30-60kg iGel?

A

small (3)/yellow

31
Q

What size and color is 50-90kg iGel?

A

Medium (4)/ Green

32
Q

What size and color is 90+kg iGel?

A

Large (5)/ Orange

33
Q

What is the max NG tube for 30-60kg?

A

12F

34
Q

What is the max NG tube for 50-90kg?

A

12F

35
Q

What is the max NG tube for 90+kg?

A

14F

36
Q

What is the size and color for 4-5ft King-Lt/LTS-D?

A

Size 3/yellow

37
Q

What is the size and color for 5-6ft King-Lt/LTS-D?

A

Size 4/red

38
Q

What is the size and color for 6+ft King-Lt/LTS-D?

A

Size 5/pruple

39
Q

What is the size and color for 6+ft King-Lt/LTS-D?

A

Size 5/purple

40
Q

What is the size for 30-50kg LMA?

A

Size 3

41
Q

What is the size for 50-70kg LMA?

A

Size 4

42
Q

What is the size for 70+kg LMA?

A

Size 5

43
Q

How many mg/mL of ketamine do you give for 50kg?

A

100mg/2mL

44
Q

How many mg/mL of ketamine do you give for 60kg?

A

120mg/2.4mL

45
Q

How many mg/mL of ketamine do you give for 70kg?

A

140mg/2.8mL

46
Q

How many mg/mL of ketamine do you give for 80kg?

A

160mg/3.2mL

47
Q

How many mg/mL of ketamine do you give for 90kg?

A

180mg/3.6mL

48
Q

How many mg/mL of ketamine do you give for 100kg?

A

200mg/4mL

49
Q

How many mg/mL of ketamine do you give for 110kg?

A

220mg/4.4mL

50
Q

How many mg/mL of ketamine do you give for 120kg?

A

240mg/4.8mL

51
Q

What happens if you do not math the patient’s rate/volume (minute ventilation)?

A

You may cause the the PT decompensate faster

52
Q

What are two key point on intubations?

A
  1. Limited to 30 seconds
  2. No more than two attempts
53
Q

What kind of PTs are at isk for respiratory failure?

A

AMS, lethargy, increasing EtCO2/continued hypoxemia

54
Q

What should you consider if NIBP (MAP) is showing decreasing trends?

A

Needle decompression

55
Q

What does D.O.P.E. mean/stand for?

A

Change in condition, decreased SpO2/vent alarms
- Dislodgement
- Obstruction
- Pneumothorax
- Equipment

56
Q

What does M.O.A.N.S. mean/stand for?

A

BVM seal
- Mask seal
- Obesity/Obstruction
- Age (>55)
- No teeth
- Sleep apnea/Stiff lungs

57
Q

What does R.O.D.S. mean/stand for?

A

Difficult extraglottic
- Restricted mouth opening
- Obstruction
- Disrupted/Distorted airway
- Still lung /cervical Spine

58
Q

What does B.U.R.P. mean/stand for?

A

Vocal cord
- Backwards
- Upwards
- Rightward
- Pressure

59
Q

What does L.E.M.O.N. mean/stand for?

A

Difficult laryngoscopy
- Look
- Evaluate
- Mallampati
- Obstruction/Obesity
- Neck rigidity

60
Q

What does S.H.O.R.T. mean/stand for?

A

Difficult cricothyroidotomy
- Surgery/Scars )or other obstruction)
- Hematoma (or infection/abscess/mass)
- Obesity
- Radiation distortion (and other deformity)
- Tumor

Protocols (19 decks)

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