Airway Management

Question 1

Adult Suction Pressure

Answer 1

-100 to -120 mmHg

Question 2

Chidren Suction Pressure

Answer 2

-80 to -100 mmHg

Question 3

Infant Suction Pressure

Answer 3

-60 to -80 mmHg

Question 4

A catheter that is too large can obstruct the ETT, how does a clinician avoid this problem

Answer 4

Never suction a pt with a catheter that has a outer diameter that is greater than one half the internal diameter of the tracheal tube. To make sure you are not using a catheter that is too large your should multiply the tube inner diameter by 2 then use the next smallest size catheter

Question 5

How long is the total suction time

Answer 5

10-15 sec

Question 6

What can vagal stimulation cause

Answer 6

Bradycardia or asystole

Question 7

Who is nasotracheal suctioning indicated for

Answer 7

Pts who retain secretions but do not have an artificial tracheal airway

Question 8

What should be considered using to help reduce mucosal trauma in the nose of patients who require long-term nasotracheal suctioning

Answer 8

NPA

Question 9

Besides trauma in the nose, what is another complication with nasotracheal suctioning

Answer 9

Contamination of the lungs with bacteria from upper airway

Question 10

Do not devote more than ______ seconds to any intubation attempt

Answer 10

30 seconds

Question 11

If intubation fails how long should you wait till you try the next intubation

Answer 11

3-5 min

Question 12

How is the epiglottis displaced with the curved or macintosh blade?

Answer 12

Indirectly by advancing the tip of the blade into the vallecula and lift the laryngoscope up and forward

Question 13

how is the epiglottis displaced with the straight or miller blade?

Answer 13

directly by advancing the tip of the blade over its posterior surface and lift the laryngoscope up and forward

Question 14

what is the appropriate tube size for women? tube length?

Answer 14

7.5-9.0; 19-21

Question 15

what is the appropriate tube size for men? tube length?

Answer 15

8.0-9.5; 21-23

Question 16

what is used to describe the administration of a sedative, hypnotic medication, and a paralyzing agent?

Answer 16

rapid sequence induction

Question 17

When does laryngeal stenosis occur

Answer 17

When normal tissue of the laryx is replaced by scar tissue

Question 18

when can a tracheoinnominate fistula occur? what is the result?

Answer 18

tracheostomy tube causes tissue erosion through the innominate artery; massive hemorrhage

Question 19

once tracheoinnominate fistula hemorrhage begins, what may slow the bleeding?

Answer 19

hyperinflation of the cuff

Question 20

what is the primary cause of tracheoinnominate fistula

Answer 20

tube movement

Question 21

What is the most common complication of suctioning?:

Answer 21

Hypoxemia

Question 22

You are about to suction a 10 year old patient who has a 6mm (internal diameter) endotracheal tube in place. What is the maximum size of catheter that you would use in this case?:

Answer 22

10 Fr

Question 23

While suctioning a patient, you observe an abrupt change in the electrocardiogram wave from being displayed on the cardiac monitor. Which of the following actions would be most appropriate?:

Answer 23

stop suctioning and immediately administer oxygen.

Question 24

Before the suctioning of a patient, auscultation reveals coarse breath sounds during both inspiration and expiration. After suctioning, the coarseness disappears, but expiratory wheezing is heard over both lung fields. What is most likely the problem?:

Answer 24

The patient has hyper active airways and has developed bronchospasm.The bronchospastic response may be particularly strong in patients with hyperactive airway disease. These patients should be accessed for the development of wheezes associated with suctioning.

Question 25

When using bulb type esophageal detention device during an intubation attempt, how do you know that the endotracheal tube is in the esophagus?:

Answer 25

the bulb fails to re- expand upon release

Question 26

When using a capnometry or colorimetry to differentiate esophageal from tracheal placement of an endotracheal tube, which of the following conditions can result in false- negative finding?:

Answer 26

Cardiac Arrest

Question 27

When performing a blind nasotracheal intubation, successful tube passage through the larynx is indicated by?:

Answer 27

a harsh cough followed by vocal silence

Question 28

In a properly performed traditional surgical tracheotomy, entrance to the trachea is made through an incision in what area?:

Answer 28

through or between the second and third tracheal rings

Question 29

The diameter of the catheter should be less than ______% of the internal diameter of the artificial airway in adults:

Answer 29

50%

Question 30

The diameter of the catheter should be less than ______% of the internal diameter of the artificial airway in infants and small children:

Answer 30

70%

Question 31

Under what age should EDD not be used for

Answer 31

Under one year

Question 32

Extension of the neck moves the tube toward the

Answer 32

Larynx

Question 33

Flexion of the neck will move the tube towards the

Answer 33

carina

Question 34

Foam Cuff

Answer 34

Designed to seal the trachea with atmospheric pressure in the cuff. Before insertion the cuff must be deflated by actively withdrawing air from the cuff with a cuff pressure device or syringe. When in position the pilot tube is opened to the atmosphere and the foam is allowed to expand against the tracheal wall. Only used in patients who have already developed tracheal injury

Question 35

How do you assess upper airway function with a fenestrated tracheostomy tube

Answer 35

Capping or placing a speaking valve on the proximal opening of the tubes outer cannula, accompanied by deflation of the cuff

Question 36

For blind nasotracheal intubation to work the patient must be

Answer 36

Spontaneously breathing

Question 37

How often should the nasal trumpet be changes

Answer 37

Every 24 hours

Question 38

Hypertension during suctioning may be due to:

Answer 38

Hypoxemia, Increased sympathetic tone secondary to stress, anxiety, pain or change in hemodynamics

Question 39

Hypotension during suctioning may be due to:

Answer 39

Cardiac dysrhythmias, Severe coughing episodes that decrease venous return

Question 40

The oxygen concentration should be increased by _____% in neonates before suctioning

Answer 40

10%

Question 41

The percent of the cuff leak should be approximately

Answer 41

15% or greater, as determined by the difference between the measured expiratory tidal volume with the cuff inflated and then deflated

Question 42

What are the open suction pressures for adults

Answer 42

-120 to -150 mm Hg

Question 43

What are the open suction pressures for children

Answer 43

100 to -120 mmHg

Question 44

What are the open suction pressures for neonates

Answer 44

-80 to -100 mm Hg

Question 45

What can too large a suction catheter combined with negative suction cause:

Answer 45

Can quickly evacuate lung volumes and can cause atelectasis and hypoxemia

Question 46

What can Vagal stimulation cause:

Answer 46

Transient bradycardia, Asystole

Question 47

What causes the need for high cuff pressures

Answer 47

the tube is too small, positioned to high in the trachea, development of tracheomalacia, high airway pressure generated by mechanical ventilation

Question 48

What does tracheal stenosis look like on a vent:

Answer 48

Appears as a fixed obstructive pattern, with flattening of both the inspiratory and the expiratory limbs of the flow volume loop

Question 49

What equipment is needed for direct nasal intubation

Answer 49

The same as for oral intubation with the addition of magill forceps

Question 50

What is the absolute contraindication for nasotracheal suctioning:

Answer 50

Epiglottitis or croup

Question 51

What is the external diameter of the endotracheal tube and the tracheostomy tube:

Answer 51

15 mm (it is universal)

Question 52

What should the RT do if resistance is felt during the insertion of the nasotracheal catheter

Answer 52

Gently twist the catheter , if twisting does not help the catheter is withdrawn and inserted through the other nostril

Question 53

Where does tracheal stenosis occur with tracheostomy tubes

Answer 53

Stenosis may occur at the cuff, tip or stoma site. The stoma site is the most common