Airway review

Question 1

What is COPD?

Answer 1

Chronic obstructive pulmonary disease

Question 2

Chronic Bronchitis classic presentations…

Answer 2

Blue (cyanotic), overweight, productive cough (sputum), excessive mucus in airway, and causes a tight airway (difficultly with inspiration and expiration)

Question 3

Emphysema classic presentations:

Answer 3

Cough only no sputum, pursed lip breathing, alveoli distinction since they aren’t opening during exhalation.

Question 4

Pulmonary Embolism

Answer 4

Thrombosis in the pulmonary arteries

Question 5

Risk factors for PE

Answer 5

Cancer, smokers, long distance travel, recent surgery, birth control, pregnancy

Question 6

Scenario question:
Answer 1, 2, 3, 4
1 suction airway first
2 open the airway
3 start bvm ventilations immediately
4 provide oxygen via nrb mask

Answer 6

2 open the airway

Question 7

Scenario question:
CHF, asthma, pneumonia, or COPD?

Answer 7

Pneumonia

Question 8

What does asthma, anaphylaxis, and COPD have in common?

Answer 8

Wheezing

Question 9

Scenario question:
Absent lung sounds, wheezing, stridor, vomiting

Answer 9

Stridor

Question 10

Describe the lung sound-Wheezing
Mnemonic for wheezing

Answer 10

Wheezing is constriction in the upper airway. AAC-Asthma, Anaphylaxis, COPD

Question 11

Describe lung sounds-Rhonchi

Answer 11

Conditions: Pneumonia
“Junk in the lungs” . Hypersecretion of mucus in lungs. Infection/mucus

Question 12

Describe lung sounds: Rales

Answer 12

Rales are fluid in the lungs. Most common in CHF patients. Pulmonary edema (fluid in lungs)

Question 13

What cartilage is an important visual landmark for endotracheal intubation?

Answer 13

Arytenoid

Question 14

What patient is most likely to have an ETCo2 of 20 mm Hg?

Answer 14

A 22 year old male being hyperventilated by bag-valve mask

Question 15

A 59 yo male became I’ll while shipping. His eyes are open but he does not respond to verbal stimulus. He has peripheral cyanosis with rapid and shallow respirations. What should you do?

Answer 15

Assist ventilations with high flow oxygen by bag valve mask

Question 16

A 30 year old male has overdosed on codeine. Vital signs are p 60, r 6 and shallow. What condition is developing?

Answer 16

RESPIRATORY ACIDOSIS

Question 17

A 50 year old male complains of shortness of breath that awoke him in the middle of the night. His medications are furosemide, lisinopril, and digoxin. Vital signs are bp 150/80, P 88 and irregular, R 24 with crackles. What should you suspect?

Answer 17

Pulmonary Edema

Question 18

What causes a pink complexion with hypoxemia?

Answer 18

Polycythemia

Question 19

A 28 year old unconscious male had his torso trapped for 3 hours under heavy debris. His jaw is clenched and you hear gurgling in the airway. What medication should you administer to facilitate securing the airway?

Answer 19

Vecuronium

Question 20

What paralytic is contraindicated in a severe trauma scenario?

Answer 20

Succinylcholine

Question 21

What secondary method should you use to confirm ET intubation placement?

Answer 21

ETC02

Question 22

Following placement of a dual lumen airway device your assessment reveals absent epigástrico sounds. You note chest rise with each assisted ventilation. Where is the location of the device?

Answer 22

Esophagus. Equal chest rise and negative epigástric sounds means correct placement.

Question 23

Common ET tube size for men

Answer 23

7-8

Question 24

Name the supraglottic airway devices (4)

Answer 24

Combi-tube, LMA, King-tube, and I-gel

Question 25

Common ET tube size for women

Answer 25

7

Question 26

How do you figure the size for a pediatric CUFFED tube?

Answer 26

Age (years) divided by 4. PLUS 3.5

Question 27

How do you figure the size for a pediatric UNCUFFED tube?

Answer 27

Age (years) divided by 4. PLUS 4

Question 28

MNUEMONIC for BLS

Answer 28

OPEN (airway), CLEAR (secretions), KEEP (opa/npa), Ventilate (BVM).

Question 29

Mallampoti Score ranges

Answer 29

1-4. 1 being best. 4 being worst.

Question 30

Score 1 on Mallampoti Score

Answer 30

VISIBLE: Soft palate, the whole uvula, and the pillors (easy airway)

Question 31

Score 2 on Mallampoti Score

Answer 31

VISIBLE: Soft palate, some of the uvula, but no pillors

Question 32

Score 3 on Mallampoti score

Answer 32

Visible: Soft palate, just the tip of the uvula (difficult airway)

Question 33

Score 4 on mallampoti

Answer 33

Visible: Hard palate only. No soft palate, no uvula. (Most difficult airway)

Question 34

6 “P’s” of RSI

Answer 34

Preparation, Pre-oxygenate, Pre-treatment, Paralysis, Place and confirm tube placement, and Post-intubation management.

Question 35

What are the three types of drugs you need to consider for RSI

Answer 35

Sedative, Paralytic, Analgesia

Question 36

What is an important consideration prior to RSI?

Answer 36

Is my airway difficult? Mellampoti score

Question 37

Warning signs of a difficult airway

Answer 37

Obesity, short/thick neck, severe overbite, small jaw/chin

Question 38

Normal pH values

Answer 38

7.35-7.45

Question 39

Normal Carbon Dioxide levels (PaCO2)

Answer 39

35-45

Question 40

Normal Bicarbonate levels (HCO3)

Answer 40

22-26

Question 41

As your RR/Depth goes up….(What happens to your CO2 levels)

Answer 41

CO2 levels go up (you’re retaining more.

Question 42

With airway obstructions, opiods, strokes, your resp. rr/depth goes down. Increasing your CO2. What is this (Resp acid/alka)?

Answer 42

Respiratory Acidosis

Question 43

As your RR/Depth goes up…your CO2 goes….

Answer 43

CO2 goes down. You’re exhaling more and more and there is less in your body.

Question 44

As your RR goes up and your CO2 goes down, what is this doing? (resp acid/alka)

Answer 44

Respiratory Alkalosis (panic attacks, pulmonary embolism, hyperventilation)

Question 45

What three drugs are paralytics?

Answer 45

Rocuronium, Succinylcholine, and Vecuronium,