Airway Management

Question 1

Upper Airway

Answer 1

All structures located above the glottic opening.

Upper respiratory tract.
Nasal Cavity, Pharynx, Larynx

Question 2

Lower Airway

Answer 2

Below the vocal cords and into the lungs.

Lower respiratory tract.
Trachea, Primary Bronchi, Lungs

Question 3

Right Lung

Answer 3

Has three lobes, upper middle and lower.

Question 4

Left Lung

Answer 4

The Left Lung only has an upper and lower lobe, making room for the heart.

Question 5

Nasopharynx

Answer 5

Situated behind the nasal cavity above the soft palate.

Question 6

Oropharynx

Answer 6

Is encompassed by the soft palate above and the epiglottis below.

Question 7

Palate

Answer 7

Forms the roof of the mouth and floor of the nasal cavity.

Question 8

Epiglottis

Answer 8

A spoon shaped plate of elastic cartilage that lies behind the tongue. Prevents food from entering the trachea.

Question 9

Larynx

Answer 9

Contains the vocal cords and regulates the flow of air to and from the lungs.

Question 10

Trachea

Answer 10

The tube like portion of the breathing or “respiratory: tract that connects the “voice box” (Larynx) with the bronchial parts of the lungs.

Question 11

Obvious Sounds of an Obstructed Airway

Answer 11

Gurgling
*Fluid build up
Coughing
*A partially blocked airway, patient is trying to free the object.
Snoring
*Vibration of respiratory structures, mainly the tongue.
Crowing
*Generally children. Airway inflammation or Obstruction.
Stridor
*High Pitched Sound caused by a blockage in the throat

Question 12

Jaw Thrusts

Answer 12

The Jaw thrust is a technique used on patients with a suspected spinal injury, patient is supine.

Question 13

Head Tilt Chin Lift

Answer 13

Primary maneuver used in any patient where spinal injury is not a concern.

Question 14

Mechanical Obstruction

Answer 14

Physical object obstructs the airway of the patient. In most cases this is the patient’s own tongue.

Question 15

Fluid Obstruction

Answer 15

Fluids, usually vomit can collect in the pharynx, causing the person to effectively drown.

Question 16

3/4 Prone

Answer 16

Recovery position is designed to prevent suffocation through obstruction of airway. Drunk patients you probably want to put in this position.

Question 17

Oropharyngeal Airway

Answer 17

An OPA, is an airway adjunct used to maintain a (patent) open airway. It does this by preventing the tongue from covering the epiglottis, which could prevent the person from breathing. All unconscious patients get an attempted OPA.

Risks

• If the person has a gag reflex they may vomit.
• Improper sizing can cause bleeding in the airway.
• When it is too large it can close the glottis and thus close the airway.

Question 18

Nasopharyngeal Airway

Answer 18

An NPA, us a tube that is designed to be inserted into the nasal passageway to secure an open airway. An NPA is used when it is impossible or inadvisable to use an OPA

Question 19

Suction

Answer 19

Suction is the removal of material through the use of negative pressure. Suctioning of the respiratory passages removes secretions that the patient cannot remove by coughing.

Complications
Arising from Improper tracheal suctioning is Hypoxia, which occurs when prolonged suctioning removes the oxygen from the patients airway thus adds to existing respiratory distress. Only suction as far as you can see in the oropharynx.

Suctioning times
Adult 15 Seconds
Child 10 Seconds
Infant 5 Seconds

Question 20

Breathing

Answer 20

As we inhale pressure decreases, as we exhale pressure increases, oxygen use is only 4-5%.

Question 21

Assessing Breathing

Answer 21

Look
Is the chest walls normal and symmetrical?
Are accessory muscles being used?
Are they cyanosed, peripheral or central?
Are they tripoding?
Is their trake even?

Listen
Can you hear airflow in your ear?
Are they able to talk in full sentences?

Feel
Can you feel airflow against your cheek?
Can you feel your hand move up and down on the patients chest?

Question 22

Breathing Rates

Answer 22

Infant 60
1 Breath Per 1 Second
Child 20-40
1 Breath Every 3-5 Seconds
Adult
1 Breath every 5-6 seconds

Question 23

Ventilation Rates

Answer 23

Infants and Children
1 every 3 seconds
Adults
1 every 5 seconds

Question 24

Respiratory Sounds

Answer 24

Wheezes
Caused by Narrowing of airways, mostly found in Asthma,

Ronchi
Usually Caused by bronchitis

Crackles
Fluids and inflammation in the bronchioles and Alveoli

Does the patient sleep sitting up? How many pillows do the sleep with?

Question 25

Oxygen Therapy

Answer 25

1-15 Litres Per Minute
Nasal Cannula 25-50% (1-6lpm)
Simple Mask 40-60% (6-10lpm)
Non Rebreather 80-95% (10-15lpm)
Bag Valve Mask (BVM) 95-100% (15lpm)

Question 26

When to bag a patient

Answer 26

Cyanosis (Blue) Around face
Breathing is under 10 or above 30
Altered LOC, Agitations, Poor Audible Lung Sounds.