Airway Management Flashcards
When is orotracheal intubation indicated?
- definitive control of airway needed
- CVS or resp distress
- risk of aspiration and failed protection
- inadequate oxygenation
- impending or existing airway obstruction
- multi-system diseases
when should intubation be done under strict conditions?
C-spine injury
Difficult orotracheal intubation?
Tumours
Trauma
Burns
Oedema
Infection
Equipment for ETT
- gloves
- suction
- laryngoscope with correct blade
- ET tube with stylet
- 10mL syringe
- BVM with O2
- nasal or oral airway
- tape
- stethoscope
What should be checked in the tube?
inflate balloon of ETT to check for leaks
What medications can be given to prepare for ETI?
Sedative and paralytic drugs:
> Etomidate
> Succinylcholine
see videos and process of intubation
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what should be auscultated?
symmetrical breath sounds
complications of ETI?
Oesophageal intubation
x hypoxemia
x hypercapnia
x death
Other:
x aspiration
x bradycardia
x spasm
x apnea
x tissue trauma
types of airway support
spontaneous
mask ventilation
supraglottic airway
ETT
Tracheostomy
Why an ET-tube?
Gold standard of airway mx
- cuff can be used to seal off the airway
- provide protection against aspiration
- pt can breathe spontaneously or be ventilated
when and why would an armoured ETT be used?
It has a metal wiring that is more resistant to compression
used in:
- non standard positions
- awake nasal fiberoptic intubation
what is a RAE tube?
bent tubes that are south = oral or north = nasal
when is an oral RAE used?
surgery on the face, tonsils and eye surgery
Pros and Cons of oral RAE?
easy to insert
kinks easily
when is a nasal RAE used?
surgery on mouth or jaw
- difficult to insert
Indications for intubation
- procedures that require immobilisations
- when ventilation is required
- securing the airway in high risk patients
give an example of an SGA
LMA = laryngeal mask airway that sit on top of the glottis
Indications for LMA
- short procedures in fasted patients who don’t require intubation
- back up in emergencies
Pros and Cons of LMA
Can breathe spontaneously but don’t offer protection from aspiration
What should be on the airway trolley?
EMAILS
E - endotracheal tubes
M - masks
A - airways
I - introducers
L - laryngoscopes
S - suction ( negative pressure ) and syringe
What is a gum elastic bougie?
Also called an “introducer”
Useful with difficult intubation
Long, flexible device can be passed through glottis and the ETT advanced over it
Role of OPA
Also known as Guedel airways
Assist in opening up the airway and relieving obstruction
Prevents tongue from covering the epiglottis and back of pharynx
Can be used to assist spontaneously breathing patients, or to improve mask ventilation
Awake patients will not tolerate an OPA (gag reflex)
Role of NPAs
Softer
Serve same function as OPAs but inserted through the nostril
Prevent tongue from obstructing pharynx
Useful if OPA fails
Useful in patients recovering from anaesthesia at risk for sleep apnoea
Insert carefully with lubrication
