Airway Management

Question 1

What does lack of oxygen lead to?

Answer 1

Ischemia (reversible)
Injury (reversible)
Infarction (irreversible)

Question 2

What stages does cellular death occur at?

Answer 2

Brain/nervous cell is 4-6min
Cardiac death is 30min
Muscle/Organ death is 1 hour

Question 3

What is required for adequate ventilation?

Answer 3

Open airway
Open respiratory tract
Adequate pulmonary blood flow
Stimulation to breathe

Question 4

What is the act of respiration?

Answer 4

The movement of gases through a membrane.

Question 5

What are the major gases of respiration?

Answer 5

Oxygen - ATP production
Carbon - primary building block for almost everything in the body
Hydrogen - body pH

Question 6

What is ventilation?

Answer 6

Process of moving air in and out of the lungs.
Inspiration and expiration

Question 7

Where is the respiratory control center?

Answer 7

The medulla

Question 8

What is inspiration?

Answer 8

Decreased thoracic pressure form increased space allows air in.

Question 9

What is expiration?

Answer 9

The chest wall relaxes and decreases thoracic space, increasing pressure.

Question 10

What muscles contract for inspiration?

Answer 10

Sternocleidomastoid muscles, pectoralis minor and external intercostal.

Question 11

What muscles contract for expiration?

Answer 11

Internal intercostal muscles contract and abdominal contract.

Question 12

How much air is exchanged between each ventilation?

Answer 12

500-800 cc

Question 13

How much air reaches the alveoli?

Answer 13

350cc

Question 14

What is minute volume?

Answer 14

Amount of air exchanged over the course of one minute

Question 15

What is tidal volume?

Answer 15

Amount of air inhaled and exhaled over the course of one ventilation.

Question 16

What is posterior sites for auscultation?

Answer 16

Paraspinal border above the scapula
And
8th intercostal space

Question 17

What are the 4 things needed for adequate oxygenation?

Answer 17

Adequate concentration of inspired O2 (FiO2)
Movement of O2 across the alveolar capillary membrane (external respiration)
Adequate RBC and Hgb to transport oxygen (oxygen tranpsort)
Offloading of O2 at the cellular level (internal respiration)

Question 18

What is hypoxia?

Answer 18

Decreased or inadequate supply of oxygen.

Question 19

What is partial pressure of O2?

Answer 19

It is the amount of O2 needed in the blood to passively diffuse into cells.

Question 20

What does pulse oximeter measure?

Answer 20

The percentage of Hgb that is saturated with O2.

Question 21

When is pulse oximetry inaccurate?

Answer 21

Reduction in peripheral blood flow produced by peripheral vasoconstriction.
Bright ambient light
Shivering
Nail polish

Question 22

What is ETCO2?

Answer 22

It measures the concentration of CO2 at the end of exhalation.

Question 23

What problem is there if the ETCO2 shows less than 10mmHg on a cardiac arrest?

Answer 23

Poor chest compressions.

Question 24

What is the order of oxygen delivery from lowest to highest?

Answer 24

Pocket mask - 16
Nasal cannula - 25-45
Simple face mask - 40-60
NRB - 80-100
BVM - 90-100

Question 25

What does each BVM hold?

Answer 25

Adult - 1l to 1.6l of air Child - 500 to 700ml Infant - 150 to 240ml

Question 26

What are some advantages to BVM?

Answer 26

Immediate means of ventilatory support Can ventilate for long periods of time without time

Question 27

What are some disadvantages to BVM?

Answer 27

Difficult skill to master Hard to maintain an adequate seal when delivering the required volume of air Hard to do BVM when holding C-spine Can cause lung damage

Question 28

What are the dangers of poor BVM?

Answer 28

Hypoxia Vomiting and aspiration Cerebral vasoconstriction Acid base imbalances Gastric insufflation

Question 29

How does OPA insertion goes for infants?

Answer 29

Straight in (no rotation)

Question 30

What are the advantages of an OPA?

Answer 30

Insertion is easy and quick Large suction tube can pass on either side

Question 31

What are some disadvantages of an OPA?

Answer 31

Does not isolate the trachea Cannot be inserted when the patients teeth are clenched Can be dislodged easily Can cause trauma if improperly placed.

Question 32

What are advantages of an NPA?

Answer 32

Insertion is quick and easy, may be inserted blindly. Gag reflex is present

Question 33

What are disadvantages of an NPA?

Answer 33

Does not isolate trachea Difficult to suction through Can cause severe nosebleed

Question 34

What are some rules to suctioning?

Answer 34

Each attempt should last 15 seconds or less Patient should be hyper-oxygenated before and after each attempt Suction on the way out

Question 35

What are some precautions to consider when suctioning?

Answer 35

Can stimulate gag reflex Can cause Vagal stimulation Can stimulate patient to cough which can increase ICP in patients with a head injury

Question 36

What are some BIADs?

Answer 36

King LT LMA I-Gel

Question 37

What are the sizes for a King-LT?

Answer 37

4-5 feet is yellow 5-6 feet is red Greater than 6 feet is purple

Question 38

What are the sizing for LMA?

Answer 38

Less than 5kg is 1 10 - 20 is 2 30-50 is 3 50-70 is 4 70-100 is 5

Question 39

What are some contraindications for BIADs?

Answer 39

Intact gag reflex Upper airway burns Ingestion of caustic substances Esophageal varices

Question 40

What are 7ps of intubation?

Answer 40

Preoxygenate - BVM 3 mins with NC 15 LPM or NRB 100% for 8 full capacity breaths. Prepare Pretreatment Paralysis Position Placement Proof

Question 41

What airways aligns the ear to sternly notch?

Answer 41

Oral Pharyngeal Laryngeal axis

Question 42

What is BIAD proof?

Answer 42

3 consecutive ETCO2 waveforms Plus positive lung sounds and negative epigastric sounds.

Question 43

How to troubleshoot a BIAD?

Answer 43

Displacement Obstruction Pneumothorax Equipment

Question 44

What are common tank constants?

Answer 44

D = 0.16 M = 1.56