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CBRC > Airway Management > Flashcards

Airway Management Flashcards

1
Q

Adult Suction Pressure

A

-100 to -120 mmHg

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2
Q

Chidren Suction Pressure

A

-80 to -100 mmHg

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3
Q

Infant Suction Pressure

A

-60 to -80 mmHg

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4
Q

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

A

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

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5
Q

How long is the total suction time

A

10-15 sec

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6
Q

What can vagal stimulation cause

A

Bradycardia or asystole

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7
Q

Who is nasotracheal suctioning indicated for

A

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

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8
Q

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

A

NPA

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9
Q

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

A

Contamination of the lungs with bacteria from upper airway

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10
Q

Do not devote more than ______ seconds to any intubation attempt

A

30 seconds

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11
Q

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

A

3-5 min

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12
Q

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

A

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

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13
Q

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

A

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

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14
Q

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

A

7.5-9.0; 19-21

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15
Q

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

A

8.0-9.5; 21-23

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16
Q

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

A

rapid sequence induction

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17
Q

When does laryngeal stenosis occur

A

When normal tissue of the laryx is replaced by scar tissue

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18
Q

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

A

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

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19
Q

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

A

hyperinflation of the cuff

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20
Q

what is the primary cause of tracheoinnominate fistula

A

tube movement

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21
Q

What is the most common complication of suctioning?:

A

Hypoxemia

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22
Q

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?:

A

10 Fr

23
Q

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?:

A

stop suctioning and immediately administer oxygen.

24
Q

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?:

A

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.

25
Q

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

A

the bulb fails to re- expand upon release

26
Q

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?:

A

Cardiac Arrest

27
Q

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

A

a harsh cough followed by vocal silence

28
Q

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

A

through or between the second and third tracheal rings

29
Q

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

A

50%

30
Q

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

A

70%

31
Q

Under what age should EDD not be used for

A

Under one year

32
Q

Extension of the neck moves the tube toward the

A

Larynx

33
Q

Flexion of the neck will move the tube towards the

A

carina

34
Q

Foam Cuff

A

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

35
Q

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

A

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

36
Q

For blind nasotracheal intubation to work the patient must be

A

Spontaneously breathing

37
Q

How often should the nasal trumpet be changes

A

Every 24 hours

38
Q

Hypertension during suctioning may be due to:

A

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

39
Q

Hypotension during suctioning may be due to:

A

Cardiac dysrhythmias, Severe coughing episodes that decrease venous return

40
Q

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

A

10%

41
Q

The percent of the cuff leak should be approximately

A

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

42
Q

What are the open suction pressures for adults

A

-120 to -150 mm Hg

43
Q

What are the open suction pressures for children

A

100 to -120 mmHg

44
Q

What are the open suction pressures for neonates

A

-80 to -100 mm Hg

45
Q

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

A

Can quickly evacuate lung volumes and can cause atelectasis and hypoxemia

46
Q

What can Vagal stimulation cause:

A

Transient bradycardia, Asystole

47
Q

What causes the need for high cuff pressures

A

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

48
Q

What does tracheal stenosis look like on a vent:

A

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

49
Q

What equipment is needed for direct nasal intubation

A

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

50
Q

What is the absolute contraindication for nasotracheal suctioning:

A

Epiglottitis or croup

51
Q

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

A

15 mm (it is universal)

52
Q

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

A

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

53
Q

Where does tracheal stenosis occur with tracheostomy tubes

A

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

CBRC (20 decks)

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