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Year 2: Nursing Adults with Acute conditions > Airway Management > Flashcards

Airway Management Flashcards

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1
Q

State 4 main structures of the Upper Respiratory Tract

A

Nose
Mouth
Pharynx
Epiglottis

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2
Q

The Nose, Mouth, Pharynx and Epiglottis are all part of what?

A

The Upper Respiratory Tract.

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3
Q

Describe the function of the Nose and Mouth

A

Intake of air

Warming and humidification of air

Filtering and expulsion of matter - sneezing

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4
Q

What is the Pharynx?

A

Cavity at the back of nose and mouth

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5
Q

What is the Cavity at the back of nose and mouth called?

A

The pharynx

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6
Q

What is the Epiglottis and its function?

A

Leaf shaped structure which closes to protect airway during swallowing

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7
Q

what is the name Leaf shaped structure which covers the trachea during swallowing?

A

The epiglottis

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8
Q

Where can the vocal chords be found?

A

In the larynx

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9
Q

What can be found in the larynx

A

vocal chords

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10
Q

How long does the trachea extend?

A

from the larynx to fifth thoracic vertabrae

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11
Q

What is dead space and why does it occur?

A

The volume of air which does not participate in gas exchange because either it remains in the conducting airways or enters a poorly perfused alveoli

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12
Q

What is Tidal volume?

A

The volume of air moved in or out of the tracheobronchial tree in a normal breath

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13
Q

How do you work out minute volume?

A

Tidal volume x respiration rate

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14
Q

How do you work out alveolar ventilation rate??

A

minute voulome -dead space.

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15
Q

Why are humans vulnerable to airway obstruction and aspiration?

A

unconsciuosness allows tongue to fall back into pharynx

proximity of oesophagus to airway - loss of glottic closure

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16
Q

Who is most vulnerable to airway obstruction?

A

any patient with altered concious state

any patient witnh loss of swallow cough gag reflexes

any patient with mechanical injury or obstruction

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17
Q

What is aspiration in acute medical situations?

A

Inhilation of of materials other than air into the airway

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18
Q

Give examples of common aspirants.

A

Mucus, Saliva, stomach contents.

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19
Q

Why can aspiration be dangerous?

A

increased risk of aspiration pneumonia.

Can cause a pulmonary edem (fluid in lungs) resulting in less o2 uptake

20
Q

What are the indication for oral intubation?

A 
Hypo ventilation
unfavovourable abg results
gcs<8
Trauma
Surgery
airway protection
drug overdose
21
Q

What should be considered if a patient has to be intubated?

A

Does patient require ITU bed

What is the purpose of intubation?

What is the underlying condition for intubation

22
Q

What specific nursing consideration should be taken when intubating a patient?

A 
equipment
drugs
patient prep
procedure
ventilation post-intubation?
observations
documentation
23
Q

What complications might
occur during orotracheal
intubation?

A

intubation of oesophagus

upper airway and nasal trauma, Tooth avulsion, laceration

24
Q

When is cricoid pressure applied?

A

during intubation of a patient where nil-by-mouth cannot be ascertained or where gastric reflux is likely.

25
Q

What is Cricoid pressure?

A

also known as sellick manoeuvre is a technique used for the endotracheal intubation of patients to reduce the risk of regurgitation

It involved applying pressure on th cricoid cartillage, compressing the esophagus and thus exposes vocal chords.

26
Q

What’s different in the asessment of total obstruction and partial obstruction?

A

Total obstruction in silent, partial obstruction is associated with noise

27
Q

List the hierarchy of airway management (9)

A

Airway clearance

recovory position

head-tilt, chin lift manoevre

oropharyngeal airway (guedel)

Nasopharyngeal airway

Bag, valve mask - 2 person ventilation

supraglottic airway

oral (maybe nasal?0 cuffed endotracheal tube

tracheostomy

28
Q

hich form of airway management is considered the gold standrd?

A

ETT - Endotracheal tube

29
Q

Describe how the recovery position lookes like.

A

patient on left side

right hand underneath cheek, other arm bent out to prevent rolling

lft leg bent out to support position

30
Q

What airway/breathing equipment may be found in the crash trolley?

A

laryngoscope

stylet

working suction

cardiac monitor,

pulse ocimeter

capnograph

31
Q

In an arrest situation are drugs required?

A

No - not priority, start CPR

32
Q

What drugs may be involved in rapid sequnce intubation or elective intubation?

A

sedation/induction agent

muscle relaxant

atropine

Reversal agens for lng acting muscle relaxants

33
Q

When administering a sedation/induction agent, what should be checked and how?

A

check BP and pulse by lacing finger on pule

once practicible check bp

34
Q

What are the contraindications for nasopharyngeal airway?

A

someone with a head injury because there is a posibilty it could reach the brain

35
Q

How should you prepare patient for intubation?

A
  • position on back
  • suction on
  • Pre-oxygenate using bag-valve mask
36
Q

describe the difference between a McItosh and a Straight curved blade laryngascope

A

McIntosh is cuved, tip lies in vallecula, blade displaces tongue and tissues forward

Miller, tip lifts epiglottis, blade flattens tissues with les displacement. ueful for children, anterior larynx, obesity

37
Q

What complications might occur during orotracheal intubation?

A

Trauma

38
Q

How is tube placement of the ETT verified?

A

Increase end tidal co2

39
Q

What is capnography?

A

also known as End Tidal CO2.

Monitors amount/concentration/partial pressure of Co2 in respiratory gases

40
Q

What is the purpose of Positive Pressure ventilation (PPV)?

A

Protect and manage airway – suction, balloon inflated
prevents aspiration

Ability to manipulate ventilation to improve blood gases and
reverse acidosis –

Increase tidal volumes to blow off CO2 and increase alveolar
ventilation

Can control respiratory rate

Can apply modes of ventilation that allow patient to do some
breathing

41
Q

What are the complications of Pstive presssure ventilation?

A

Protect airway – risk of tube blockage

Invasive ventilation increases risk of chest infection, ventilator acquired pneumonia
(VAP)

Presence of oral tube very uncomfortable for patient so need for sedation

Risk of biting down on tube

Oral hygiene difficult (VAP?)

Large tidal volumes can cause barotrauma

High O2
levels can cause inflammation – risk of ARDS

42
Q

what is non-invasive ventilation (niv)?

A

the provision of
ventilatory support through the patient’s upper airway
using a mask or similar device’

This may be:
• Continuous positive airway pressure (CPAP) or
• Bilevel positive airway pressure (BiPAP

43
Q

wHAT IS THE AIMS OF NON-INVASIVE VENTILATION?

A
  • Decreased work of breathing
  • Increased tidal volume
  • Decreased respiratory rate
44
Q

What are the aims for non-invasive ventilation?

A
  • Decreased work of breathing
  • Increased tidal volume
  • Decreased respiratory rate
45
Q

What are the indications for non-invasive ventilation?

A

Acute respiratory failure

Hypercapnic acute respiratory failure

Post-extubation difficulty

Weaning difficulties

Post-surgical respiratory failure

Acute respiratory failure in obesity hypoventilation syndrome

Patients ‘not for intubation’

Hypoxaemic acute respiratory failure-there is limited evidence to support the use of NIV, but patients presenting with cardiogenic
pulmonary o

46
Q

How do you insert a guedell into patient?

A

Insert upside down first in mouth then rotate.

47
Q

What does MAP stand for?

A

Mean Arterial Blood pressure

Year 2: Nursing Adults with Acute conditions (12 decks)

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