Airway Part 2 Flashcards
Preoxygenation
100% O2
normal Vt 3-5 minutes or 8 vital capacity breaths within 60 sec
minimum 5L FGF
Adequate preoxygenation
movement of bag
well defined ETCO2
Fraction of expired O2 90% or greater
Apneic oxygenation
15LPM with nasal cannula
transnasal humidified rapid insufflation ventilatory exchange
60LPM for 3 min
Cricoid pressure
10-20 N when awake
30-40 N after loss of consciousness
remove if vomiting occurs- rupture esophagus
common cause of unanticipated difficult airway
lingual tonsil hyperplasia
indications of difficulty with SAD
placement requires multiple attempts or providers
leak pressure less than 10-15 cmH2O and poor expired Vt
CICO is more common in what population
pregnant patients
11 extubation criteria
- acceptable hemodynamics
- normothermia
- ability to maintain patent airway
- adequate muscle strength
- acceptable metabolic indicators (lytes and ABG)
- acceptable hgb
- adequate analgesia for optimal resp. effort
- adequate respiratory mechanics
- ability to maintain adequate oxygenation with FiO2 <50
- ability to maintain alveolar ventilation
- acceptable spontaneous RR
how to assess if the patient has the ability to maintain patent airway
return of laryngeal/cough reflexes and appropriate LOC
adequate resp mechanics
vital capacity >15ml/kg
max neg insp force >-20cmH2O
adequate Vt (4-5ml/kg)
adequate oxygenation for extubation
spO2>90
PaO2>60
adequate ability to maintain alveolar ventilation
PaCO2 <50
laryngospasm can affect which muscles
tensing of the cords by the cricothyroid muscles
adduction of the cords by the thyroarytenoid and lateral cricoarytenoid muscles
cricothyroid muscles are innervated by what
SLN
