Airway Management

Question 1

Ventilation ratio for cardiac arrest (no advanced airway)

Answer 1

2 ventilations: 30 compressions

Question 2

Ventilation ratio for cardiac arrest (with advanced airway)

Answer 2

1 ventilation every 6 seconds

Question 3

Ventilation ratio for respiratory arrest (has pulse, not breathing)

Answer 3

1 ventilation every 6 seconds

After 2 mins check for a pulse

Question 4

Effects of excessive ventilations and/or large tidal volumes

Answer 4

1. Gastic insufflation causing aspiration of gastric contents
2. Increases intrathoracic pressure: decreases venous return to heart and lowers cardiac output
3. Lowers survival

Question 5

Tidal Volume for arrest patients

Answer 5

500-600 ml (enough for chest rise) and/or half a bag squeeze

Question 6

Step #1 in Airway Management

Answer 6

Opening the Airway

• Head Tilt/Chin Lift (no head/neck injury)
• Jaw thrust (head/neck injury present)

Question 7

Step #2 in Airway Management

Answer 7

Clear Airway

-suction if copious secretions, blood, FB, vomit

Question 8

Oropharyngeal Airway (OPA)

Answer 8

• Need to be unconscious/no gag reflex
• Size: corner of mouth with tip to end of mandible
• First inserted upside down, then rotated 180 degrees
• Provides access to throat for suctioning and prevents biting of advanced airway

Question 9

Nasopharyngeal Airway (NPA)

Answer 9

• Can be conscious and with gag reflex to use
• Sizing: From tip of nose to earlobe
• Inserted w/lube and perpendicular to face
• Avoid using with head or cranial fractures

Question 10

S/P Airway Adjunct Insertion

Answer 10

• Listen for breath sounds

- Ventilate every 6 seconds without interrupting chest compressions

Question 11

One-Person Bag-Mask Ventilation

Answer 11

• Position yourself directly at top of patient’s head
• Perform head tilt and press mask into face while lifting jaw into mask
• “C” with thumb and pointer finger; thumb at bridge of nose
• “E” with remaining fingers to lift jaw (opening airway)
• Squeeze bag-mask over 1 second to deliver one breath
• Effective=Visible chest rise

Question 12

Two-Person Bag-Mask Ventilation

Answer 12

• Mask holder: uses both hands with each using “C” and “E” shapes
• Bag-Holder: Delivers breath with 2 hands

Question 13

Pressing too hard on mask during ventilation causes…

Answer 13

the jaw to be pushed down and can obstruct the airway

Question 14

Waveform Capnography Uses

Answer 14

1. Confirms correct placement of airway adjuncts

2. Deems effectiveness of chest compressions

Question 15

How is Waveform Capnography work? What does it work?

Answer 15

1. Measures amount of CO2 exhaled
2. Waveform rises as patient exhales CO2 and falls to zero when patient inhales
3. End-tidal CO2 is the highest point on the wave

Question 16

ROSC can be indicated by…

Answer 16

A sharp increase in end-tidal CO2

Question 17

During CPR resuscitation, higher cardiac output can be evidenced by…

Answer 17

A higher end-tidal CO2 reading

Question 18

What end-tidal CO2 reading indicates that ROSC is unlikely?

Answer 18

Less than 10 mmHg

Question 19

Hyperventilation and normal perfusion have what end-tidal CO2 reading?

Answer 19

Less than 35 mmHg

Fast breathing, shorter exhales, less CO2

Question 20

Hypoventilation and normal perfusion have what end-tidal CO2 reading?

Answer 20

More than 45 mmHg

Slow breathing, longer exhales, more CO2

Question 21

How do colorimetric CO2 detectors work?

Answer 21

Changes color from yellow to purple when CO2 is detected