Airway Management Flashcards
does smoking make someone ASA II?
Does day one of quitting change it?
yes…
yes
how many fingers do you need to not be at risk for jaw opening distance and thyromental distance?
3 fingers
Mallampati Score Classification class 1? class 2? class 3? class 4?
1: can see all of uvula and tonsils pillars
2: can see part of uvula and soft palate with sauces
3: soft palate and base of uvula
4: hard palate only
oropharyngeal airway management
sized from what to what?
can it be placed in conscious patient?
sized from commissure to mandible angle
cannot be placed in conscious
nasopharyngeal airway management
sized from what to what?
can it be placed in conscious patient
avoid in patients with history of what 2 things?
MUST BE LUBRICATED
from naris to mandible angle
can be placed in conscious
avoid with history of epistaxis and cleft palate repair
Supraglottic Airway does cuff seal? what feature reduces aspiration risk? what feature prevents rotation? can tube be crushed
no
gastric channel
oblong shaft
no (internal bite block)
what is used to break laryngospasm?
bag valve mask
or jaw thrust technique
T/F: bag valve mask doesn’t require e cylinder of oxygen
T/F: the bag valve can inflate a patient’s stomach if you are not careful
false
true
What is the most important object in the room that is required for all sedation cases?
Yankauer suction (oral surgery suction)
Apnea rescue algorithm signs? if cause is obstruction? if cause is pharmacologic? Last step needed for rescue?
signs: no delay in stethoscope, capnography 3-4 sec. delay, oximetry 30-45 sec delay
obstruction: head tilt, remove debris
pharm: most likely be opioid or benzo so reverse those
MECHANICAL VENTILATION
What is it called when vocal cords spasm preventing breathing?
what causes this?
laryngospasm
can be caused by irritation of cords from saliva/blood/debris
Laryngospasm rescue algorithm signs? steps? pharmacological help? surgical help?
signs: crowing sound, rocking motion
need to stop irritating factor, provide jaw thrust (pain is respiratory stimulus), provide positive pressure with bag valve (hold pressure for 10-20 sec), then go to pharm
Pharm: 20-30 mg Propofol IV, succinylcholine
surgical: cricothyrotomy if all else fails
what is it called when bronchiolar smooth muscle constricts?
bronchospasm
what causes a bronchospasm?
irritation of small airways, smoking/pollution/infection/instrumentation/asthma/etc.
bronchospasm rescue algorithm signs? steps? pharm? what do you need to rule out
signs: wheezing/shark fin capnography, increased expiratory time
administer albuterol and 10 mcg IV epinephrine
rule out anaphylaxis
do healthy patients need difficult airway algorithm?
no
what color light is absorbed by oxyhemoglobin?
what color is absorbed by deoxyhemoglobin?
- red
2. infrared
can oxygen bind to ferric or ferrous state hemoglobin? What are the states of hemoglobin called when they are in the ferric and ferrous state?
ferrous state can bind oxygen
ferrous: oxyhemoglobin
ferric: deoxyhemoglobin
if you’re SpO2 monitor is stuck at 85%, what are you reading?
methemoglobin (bound to carbon monoxide)
does carboxyhemoglobin absorb infrared or red light?
red light
T/F: fingernail polish can not affect pulse oximetry
false
T/F: when oxygen binds to hemoglobin the affinity for more oxygen incrases
true
does a tense or relaxed form bind to oxygen better?
relaxed
is the tensed form of hemoglobin found in muscles or the lungs?
muscles
conditions that push hemoglobin/oxygen reaction to the tensed form?
increased temp.
increased 2,3 BPG
increased CO2
decreased pH
conditions that push hemoglobin/oxygen reaction to the tensed form?
decreased temp
deceased 2/3 BPG
decreased CO2
increased pH
oxygen dissociation curve what type of hypoxia is 90-94% what type is 85-89%? <84%? <65%?
mild
moderate
severe
cyanosis
when hypoxia happens, does oximetry show it right away?
no, there is always a delay of at least 20-30 seconds up to 90 seconds
please tell me you know hypertension….
if you don’t, get it together
3 wire cable placement for ECG?
white cable: right arm (right is white)
black cable: left arm (smoke over fire)
red cable: lower limb
T/F: use of capnogrphy is now required by law in all sedation cases
true
what provides instantaneous recognition of hypoxia
precordial stethoscope
