Airway Management - CA Flashcards
Nose, mouth, pharynx, and larynx
Upper airway
Trachea, bronchi, bronchioles, terminal bronchioles, respiratory bronchioles, and alveoli make up?
Lower airway
This anatomical structure in the normal adult is at the level of the fifth cervical vertebra?
Glottis
What is usually the main cause of airway obstruction?
Tongue
What maneuver will typically relieve a tongue obstruction?
Chin lift/jaw thrust
What do you do if a chin lift or jaw thrust will not relieve the airway obstruction?
Move to an oral or nasal airway
True or false
We should use oral airways for patients with active gag reflexes
False
What are two insertion techniques for inserting an oral airway?
- Tongue depressor
2. Insert and rotate
These type of airways are less stimulating and often better tolerated than oral
Nasal airways
What is considered to be “crucial” when using nasal airways?
Depth of insertion
What is the number one complication of nasal airways?
Hemorrhage
What are some advantages to using a laryngeal mask airway?
- They can be used whenever a face mask can be used.
- Allows one handed ventilation
- If properly inserted it can form a seal around the larynx
- Less stimulating than endotracheal intubation
- Can manage a difficult airway
Suspected gastric contents, gross obesity, pregnancy, acute abdomen, thoracic injury, heavy opiate intoxication, hiatal hernia, and low pulmonary compliance are all contraindications for what type of airway?
Laryngeal mask airway
When using a laryngeal mask airway, ventilatory pressure should not exceed 20 mm because?
Increased risk of aspiration
Laryngoscopes are always held in the right or left hand?
Left
What is another name for a curved blade?
MacIntosh
What is another name for a straight blade?
Miller, WisHipple
What is the typical size of an endotracheal tube for females?
7.0-7.5
What is the typical size of an endotracheal tube for males?
7.5-9.0
The cuff pressure in an endotracheal tube should not exceed ______ torr (capillary pressure)
25
What is the initial step in ensuring successful intubation (especially in obese or pregnant patient)?
Positioning the patient
The _________ position enables to align the axes of the patient’s mouth, pharynx, and larynx permitting direct visualization of the larynx during Layngoscopy
Sniffing
What is something you should always have at hand when intubating?
Suction
What is the name of the maneuver where you use your index finger to pull the right incisors toward the operator?
Scissor maneuver
Tip of blade rests in the valecula and the epiglotis is lifted indirectly and incompletely – does this describe a curved or straight blade?
Curved
Tip of the blade is inserted beneath the epiglotis and lifts it directly and more completely – does this describe a curved or straight bladeE?
Straight
What is the advantage of a curved blade compared to a straight blade?
Easier, better tongue displacement
What is the advantage of a straight blade?
Enhanced visualization
What is the name of the classification used to view the larynx?
Cormack and Lehane
Cormack and Lehane Grade 1
Full view of the glottis
Cormack and Lehane Grade 2
Only the posterior commissure is visible
Cormack and Lehane Grade 3
Only the epiglottis is seen
Cormack and Lehane Grade 4
No epiglottis or glottis structure visible
What are some common mistakes people make when using an ETT?
Inserting the blade too far
Pulling the Lever
Inserting the ETT too far
How do we objectively k now that we have correct placement of an ETT?
Continued presence of ETCO2 (six breaths) and interpreted CXR
Normal adults should be able to open their mouth a minimum of _____ to _____ centimeters
4 to 6 (3 fingers)
What are some predictors of difficult intubation?
Distorted neck mobility, protruding upper incisors, permanent dentures or caps, missing or mal-aligned teeth, macroglossia or glossal edema, morbid obesity
