Airway management and capnography Flashcards
What are the causes of airway obstruction?
Foreign bodies - Blood, teeth ect
Laryngeal - Spasam/ Obstruction
Bronchaeil - Secreations, spams and odoema
What does a silent chest indicate?
Complete obstruction
What noises indicate a partial obstruction?
Gurgling, Striddor, Wheeze and snoringn
What noise is likely to indicate a lower airway obstruction?
Wheeze
What are the key steps of treating a PT who is chocking, but still conscious?
- Encourage to cough
- 5 back slaps
- 5 Abdominal thrusts
- Repeat until unconscious or obstruction removed
What is the correct position to deliver a back slap?
- Slightly bent over, with the arm to support to pt.
- Using the palm of the hand slap between the PT shoulder blades.
When would you complete chest thrusts instead of abdominal thrusts?
In paediatrics under 1.
What may be caused by CNS depression?
- Loss of airway patency
- Loss of protective reflexes
How would you inspect the oropharynx?
Using a cross finger technique
What are the methods of clearing an airway?
- Suction
- Postural drainage
- Magill forceps
What are the 2 sizes of larygoscope blades?
Mac 2 - Child
Mac 4 - Adult
What are the disadvantages of suction?
- Further oral trauma
- Further push obstruction
- Cause bradycardia due to the stimulation of the vagus nerve
What type of suction catheter should be used whilst te vehicle is in motion?
- Soft tip
What pressure should be used when using suction on paediatrics?
<120mmhg
What are the indications for Laryngoscopy?
- Unconscious Pt, with a foreign body to ocluding the airway.
What are the contraindications for larygoscopy?
- if the Pt can cough
- Conscious patients
How is an OPA measured?
From the patients incisors to the jaw
How is an NPA measured?
From the nose to the tragus
Under what age do you not invert an OPA and why?
Under 8’s due to the development of the soft pallet
What are the contra indications for an NPA?
- Recurrent epistaxisis
- Nasal polyps
- Not tolerated
- under 12’s (Due to adenoids)
What sizes of Igel are used in paediatrics and neonates?
- Neonates - Pink (Size- 1)
- Paediatrics - Grey (Size - 2)
What weight of patient is indicated for a size 5 (Orange) Igel?
- 90+ kg
What weight of patient is indicated for a size 3 (Yellow) Igel?
30 - 60kg
What what of patient is indicated for a size 4 (Green) Igel?
50-90kg
Where does the cuff of the Igel seat?
- Proximal larygopharynx
What should be checked once the Igel is inserted?
- Look for rise and fall of the chest
- Auscultate the chest
- Confirm EtCO2
What 2 procedures can be used to assist with intubation?
- BURP
- Cricoid pressure
What are the 2 types of BVM Grip ?
- CE
- 2 Person grip
How is a tidal volume calculated on a parapack?
7ml per kg of person
What needs to be altered if the parapac presents with a high pressure alarm?
- Decrease tidal volume
- Check for obstruction
Define “Capnohraphy”
The measurement of CO2 in the expired breath.
Define “Capnometry”
The numeric measurement of CO2
Define “End tidal CO2”.
The level of PaCo2 released at the end of expiration (In kPa)
What is the normal range for end tidal Co2?
4.5-6
What does the box waveform demonstate?
- Good placement of airway
- Confirmation of adequate compressions
- Effective ventialtions
What factors effect EtCo2?
- Cell metabolism
- Venous return
- Pulmonary circulation
- Pulmonary Ventilation.
What does a prolonged respiratory phase (Shark fin) show?
- Astha/COPD
- Slow Exhalation
