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Chapter 15 > airway management > Flashcards

airway management Flashcards

1
Q

what are the three oxygen delivery devices primarily used in the pre-hospital setting?

A

cannula, nrb and bag valve type devices.

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2
Q

a nrb at 15 liters provides what percentage of inspired oxygen (Fi02)?

A

90-100%

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3
Q

contraindications for a nrb use are?

A

apnea and poor respiratory effort.

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4
Q

a nc has what flow rate?

A

1-6 lpm.

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5
Q

a nc provides what percentage of oxygen to the patient?

A

24-44%

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6
Q

who is a nc most beneficial for?

A

a pt with copd who is on long term o2.

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7
Q

what is the difference between a nrb and a partial nrb?

A

a partial lacks the one way valve between the mask and the reservoir.

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8
Q

what percentage of o2 does a pt receive using a partial nrb?

A

they receive 35-60% at 6-10 lpm and increasing above 10 lpm will not enhance the concentration.

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9
Q

what does the venturi mask allow for? f

A

giving a specific delivery amount to the pt.

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10
Q

what are the delivery percentages for a venturi mask?

A

24, 28, 35, or 40% o2.

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11
Q

with venturi masks what type of pts are they ideal for?

A

copd pts.

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12
Q

how much humidity is contained in normal stored 02

A

zero

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13
Q

during normal ventilation the chest wall movement works similar to a pump. what does the pressure change within the thoracic cavity to do the heart?

A

it helps draw venous blood back into the heart which improves preload. pg. 757

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14
Q

cardiac output is classified as?

A

stroke volume multiplied by the pulse rate. pg 757

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15
Q

what is the percentage of oxygen in your exhaled air?

A

16%

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16
Q

the bvm can provide up to what percentage of 02?

A

100%

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17
Q

what is the most common device used to ventilate pts in the prehospital setting?

A

bvm

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18
Q

the total amount of gas in the reservoir bag of a bvm in an adult size is what?

A

1200-1600 ml.

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19
Q

the total amount of gas in the reservoir bag of a bvm in a pediatric size is what?

A

500-700ml.

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20
Q

the total amount of gas in the reservoir bag of a bvm in an infant size is what?

A

150-240ml.

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21
Q

what volume of air provided to an adult pt via bvm will create visible chest rise?

A

500-600ml.

22
Q

how long should it take you to provide one breath with a bvm?

A

1 second.

23
Q

breaths given with a bvm too forceful or too fast can result in what?

A

gastric distention and decreased venous return to the heart (preload).

24
Q

ventilation rate for an adult is what?

A

10-12 bpm

25
Q

ventilation rate for infants and children is what?

A

12-20 bpm.

26
Q

a condition that may occur when using a manually triggered ventilation device that is providing too high of a pressure is?

A

pneumothorax.

27
Q

automatic transport ventilators allow you to adjust what?

A

respiratory rate and tidal volume

28
Q

using an automatic transport ventilator what formula can you use for determining estimated tidal volume?

A

6-7ml per kg.

29
Q

what prehospital conditions has CPAP been found to provide excellent treatment for?

A

acute pulmonary edema, obstructive lung disease (copd), and acute bronchospasm like asthma. this is especially true when used with a beta 2 agonist.

30
Q

what does CPAP do?

A

it increases pressure in the lungs, opens collapsed alveoliand prevents further aveolar collapse (atelectasis), pushes more o2 across the alveolar membrane, and forces interstitial fluid back into pulmonary circulation.

31
Q

contraindications for CPAP?

A

respiratory arrest, hypoventilation, signs of a pneumo or chest trauma, tracheostomy, active gi bleeding or vomitting, pt unable to follow verbal commands, the inability to properly fit the device, and the inability to tolerate the mask.

32
Q

the peep valve on the CPAP is generally used in what pressure range?

A

5-10 cm H20.

33
Q

most cpap machines can provide what percentage of 02? however some can provide up to what %?

A

30-35% and up to 80%

34
Q

does gastric distention occur most often with adults or children?

A

children.

35
Q

can activated charcoal be administered via a gastric tube?

A

yes

36
Q

what are the two types of gastric tubes?

A

ng and og.

37
Q

what should extreme caution be taken in regards to the use of gastric tubes?

A

when the pt has a known esophageal disease such as tumors or varices and they should never be used in a patient that doesnt have a patent esophagus.

38
Q

is og or ng tube the preferred method for a responsive pt?

A

ng tube for responsive patients.

39
Q

a contraindication of a ng tube is?

A

facial trauma particularly midface fractures and skull fractures. for these patients use the og.

40
Q

how do you measure a ng tube?

A

measure from the nose to the ear to the xiphoid process.

41
Q

how do you confirm the placement of a ng tube?

A

auscultate over the epigastrium while injecting 30-50ml of air into the tube and or observe gastric contents in the tube.

42
Q

what is the main difference between the ng and og tube?

A

the og tube can be used in pts with severe facial trauma, and you can use larger tubes which is more effective when providing gastric lavage.

43
Q

when is the og tube used?

A

when pts are unresponsive with no gag reflex.

44
Q

when is the og tube inserted?

A

almost always the tube is placed after the pt has been intubated. if done before intubation it may block the vocal cords during the intubation process.

45
Q

how do you measure a og tube?

A

nose to ear to xiphoid process

46
Q

how do you confirm og tube placement?

A

auscultate over the epigastrium while you inject 30-50 ml of air into the og tube and or observe gastric contents in the tube.

47
Q

what is the difference between laryngectomy and tracheostomy?

A

the laryngectomy the larynx is removed and a tracheostomy is a surgical opening into the trachea thus creating a stoma.

48
Q

when ventilating a stoma what size mask should you use to ventilate the pt with a bvm?

A

infant or child size. which ever makes a better seal over the stoma.

49
Q

what can occur if the tracheostomy tube becomes dislodged?

A

stenosis or narrowing may occur. stenosis if life threatening because as the soft tissue swells it impairs the pts ventilatory ability.

50
Q

if a dental appliance if found and is well fitting should you leave it or take it our?

A

leave it in due to the fact it helps maintain the structure of the face.

51
Q

should you remove dental appliances before you intubate a pt?

A

yes it is difficult to remove them after the tube has been placed and its dangerous.

52
Q

when a patient has severe facial trauma who is breathing inadequately and has severe oropharyngeal bleeding you should do what?

A

suction the airway for 15 seconds unless its children or infants and then provide ppv for 2 minutes.

Chapter 15 (1 decks)

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