Airway Management - Opening, Suctioning, Adjuncts, & Maintaining Flashcards
To most effectively open the airway and assess breathing, the unresponsive patient should be in the ___ position
Supine
If a situation delays placement in the supine position, the patient’s airway must be ___
Opened and assessed in the position in which the patient is found
If a patient is found in the prone position, they must be ___
Repositioned to allow for the assessment of airway and breathing and to begin CPR
When rolling a patient with a suspected spine injury, who calls out the count?
The person controlling the head
Maneuver to open the airway in a patient without a suspected cervical spine injury
Head tilt-chin lift maneuver
Do not use your ___ to lift the chin
Thumb
The completed jaw-thrust maneuver should open the airway with the mouth ___
Slightly open and the jaw jutting forward
Patients with a history of rheumatoid arthritis or Down syndrome are predisposed to ___
Instability of the cervical spine, specifically at the 1st and 2nd cervical vertebrae
Regular chest wall movement indicates ___
A respiratory effort is present
How to open a patients mouth while conducting airway maneuver
Place the tips of the index finger and thumb in the patient’s teeth. Push the thumb on the lower teeth and index finger on the upper teeth. Called the cross-finger technique
If the airway is not clear, you will force the fluids and secretions ___
Into the lungs, resulting in aspiration
After the airway, the next priority is ___
Suctioning
If you hear gurgling, ___
The patient needs suctioning
A fixed suctioning unit should generate a vacuum of more than ___
300 mm/Hg
Plastic, rigid pharyngeal suction tips
Tonsil tips (Yankauer tips or DuCanto catheter)
Nonrigid plastic catheters
French or whistle-tip catheters
Suctioning unit should be fitted with ___
- Wide-bore, thick-walled, non kinking tubing
- Tonsil tips
- Nonrigid plastic catheters
- Nonbreakable, disposable collection bottle
- Water for rinsing the tips
Hollow, cylindrical device that is used to remove the fluids from the patient’s airway
Suction catheter
A ___ is the best type of catheter for infants and children
Tonsil-tip catheter
Tips with a curved contour allow for ___
Easy, rapid placement in the oropharynx
___ are used to suction the nose and thin secretions in the back of the mouth, and in situations in which you cannot use a rigid catheter
French or whistle-tip catheters
An opening through the skin that goes into an organ or other structure
Stoma
What kind of catheter cannot be used in a patient with a stoma?
Rigid catheter
When measuring for a catheter, use the same techniques as when measuring for an ___
Oropharyngeal airway
Don’t touch the back of the airway with a suction catheter because it can ___
Stimulate the gag reflex
Aggressive suctioning can also stimulate the ___ and cause ___, especially in ___
- Vagus nerve
- Bradycardia
- Infants and small children
Aspiration increases the risk of mortality by ___
30% to 70%
Between suction attempts ___
Rinse the catheter and tubing with water to prevent clogging with dried vomitus or other secretions
When suctioning a conscious or semiconscious patient ___
Use extreme caution and put the tip in only as far as you can visualize
How to measure the catheter?
Measure from the corner of the mouth to the earlobe or angle of the jaw
Do not suction while ___
Inserting the catheter
When suctioning, turn the patient’s head ___, unless ___
- To the side
- You suspect a cervical spine injury
Apply suction in a ___ motion as you ___
- Circular motion
- Withdraw the catheter
If an obstruction is in a patient’s mouth that cannot be suctioned out ___
Log roll them to the side and carefully clear the mouth
Only attempt to remove an object from the mouth if it is ___
Visible
If a patient requires assisted ventilations is producing frothy secretions as quickly as you can remove them ___
Alternate suctioning with ventilations
The primary function of an airway adjunct
Prevent obstruction of the upper airway by the tongue and allow the passage of air and oxygen to the lungs
Two principle purposes of an oropharyngeal airway
- Keep the tongue from blocking the upper airway
- Make it easier to suction the oropharynx if necessary
How to suction with an oropharyngeal airway
Through an opening down the center or along either side of the airway
Indications for the oral airway
- Unresponsive patients without a gag reflex (breathing or apneic)
- Any apneic patient being ventilated with a bag-mask device
Contraindications for the oral airway
- Conscious patients
- Any patient who has an intact gag reflex
Protective reflex mechanism that prevents food and other particles from entering the airway
Gag reflex
If the patient gags while you are attempting to insert an oral airway ___
Immediately remove the adjunct and prepare to log roll the patient and suction the oropharynx, should vomiting occur
An oral airway is a safe way to maintain an airway of a patient with a possible ___
Spinal injury
An oral airway does not replace ___
Manual maneuvers
If the oral airway is too large ___
It could push the tongue back into the pharynx, blocking the airway
If the oral airway is too small ___
It could block the airway directly like any foreign body obstruction
How to measure for oral airway
Measure for the earlobe or angle of the jaw to the corner of the mouth
How to insert oral airway
Insert upside down and then rotate 180º
The flange of the oral airway should rest ___
Against the lips or teeth
In children, the only acceptable method of inserting an oral airway is to ___
Use a tongue blade to hold the tongue down while inserting the airway. Rotating it in the posterior pharynx may cause damage
If you encounter difficulty while inserting the oral airway, ___
Insert the airway with a 90º rotation
When inserting an oral airway with a 90º rotation
Use a bite stick or tongue depressor to depress the tongue, rusting it remains forward
If a patient becomes responsive and regains the gag reflex after an oral airway is inserted ___
Gently remove the airway by pulling it out, following the normal curvature of the mouth
Usually used with an unresponsive patient or a patient with an altered LOC who has an intact gag reflex and is not able to maintain their airway spontaneously
Nasopharyngeal airway
Coat the nasal airway with ___
Water-soluble lubricant
Indications for the nasopharyngeal airway
- Semiconscious or unconscious patients with an intact gag reflex
- Patients who otherwise will not tolerate an oral airway
Contraindications for the nasal airway
- Severe head injury with blood draining from the nose
- History of fractured nasal bone
How to measure for a nasal airway
Measure from the tip of the nose to the earlobe
Which nostril should the nasal airway be placed?
The larger one
With a nasal airway, if using the right nare, ___
The bevel should face the septum
With a nasal airway, if using the left nare, ___
- Insert the airway with the tip of the airway pointing upward, which will allow the bevel to face the septum
- Insert until resistance is met and rotate 180º
The curvature of the nasal airway should follow ___
The curve of the floor of the nose
When the nasal airway is inserted completely ___
The flange rests against the nostril. The other end opens into the posterior pharynx
Used to help maintain a clear airway in an unconscious patient who is not injured and is breathing on their own with a normal respiratory rate and adequate tidal volume
Recovery position
The recovery position is not appropriate for patients with ___
Suspected spinal, hip, or pelvic injuries or for patients who are unconscious and require ventilatory assistance
