ALS AIRWAY MANAGEMENT Flashcards
In what conditions does the laryngeal mask airway have an advantage over the endotracheal tube?
- When access to the patient is limited.
- There is a possibility of unstable neck injury .
- Appropiate positiong of the patient for endotracheal intubation is impossible.
What is Capnography?
- Noninvasive, continuous measurement of exhaled carbon dioxide concentration over time.
Give indications for Endotracheal Intubation?
- Failure of airway maintenance or protection
- Failure of ventilation or oxygenation
- Anticipated clinical course seems to be worsen
What does BURP stands for?
B -backwards
U -upwards
R- rightward
P-pressure
Differintiate between Mallampati Class1,2,3 &4
Class 1 Hard palate, soft palate, ovule & pillars visible
Class 2 Hard palate, soft palate, Uvula visible
Class 3 Hard palate, soft palate visible
Class 4 Only hard palate visible
Differentiate between Cormack Grades 1, 2, 3 &4
Grade1 Glottis& Epiglottis fully visible
Grade2 Glottis & Epiglottis partially visible
Grade3 Only epiglottis partially visible
Grade4 None visible
Give the methods of confirming the ET tube?
Chest rise
Air entry
Fogging of ETT
EDD
Capnometer
Capnography
Which factors can Limite Colorimetric Capnometry reading?
- Decreased cardiac output
- Low metabolic CO2 production
What complications whould arrise when inserting an advance airway to deep in right mainstem bronchus?
Atelactasis and pulmonary insufficientcy on left side of lung.
How long should a patient be oxygenated befor tracheobroncheal suctioning can be performed?
5 minutes.
Why should intubated patient require waveform capnography?
- Verify endotracheal(ET) tube placement.
- Monitor or detect ET tube dislodgement.
- Monitor loss of circulatory function
- Assess the adequate of CPR
- Confirm return of spontaneous circulation.
Why is it dangerous to sedate a patient with a poor lung pathology?
The patient may suffer respiratory arrest.
Advantages of an laryngeal mask airway?
Less skilled training and maintenance required.Laryngoscopy and visualisation of vocal cords not required. Minimal spinal movement.Endotraceal intubation can be achieved through some LMA`s.
What consideration should be given to the saturation values observed in monitoring of your patient with CO poisoning?
A Saturation monitor is useless when monitoring CO poisoning as it will show that the haemoglobin is completely saturated but in this case with the wrong gas.
List the indications for mechanical ventilation?
Apnea
Neuromuscular paralysis.
Unconscious.
- Inadequate Resp Effort.
- Tachypnea.
- Hypoxia
- Hypercarbia
- Cyanosis
Severe closed head injury with need for hyperventilation
List the complication of mechanical ventilation?
- Ventilator-induced lung injury
- Barotrauma
- Volutrauma
- Ventilator-associated pneumonia
- Oxygen toxicity
- Cardiovascular effects
When do you use Mnemonic SHORT?
Cricothyrotomy
What does the R in Mnemonic SHORT stand for?
R-Radiation
Give the limitation of SpO2?
- Motion artefact
- Abnormal haemoglobin
- Peripheral vasoconstriction
- Anaemia
- Dark nail polish
- Ill fitting probe
- External light
Give the advantages of nasal cannulae?
Well tolerated
Comfortable
Convenient
Why must you give Humidified O2?
Prevents
• Impaired mucus transport
• Ciliary dysfunction
• Retention of secretions
• Pneumonia
List the disadvantages of cricoids pressure
- Extreme or large quantities of enemies if pressure is removed
- Should maintained until patient is intubated
- Requires 2 or more providers
- If cervical spine injury is present, may cause further injury
List the contra-indications for ET intubation
- Adequate ventilation and airway maintenance
- Whom intubation would be impossible
- Neck trauma or swelling that would compromise the airway.
- Upper airway obstruction
- Epiglottis
Give the formula to calculate O2 duration for your transportation?
O2 duration=Cylinder pressure (Bar) X Cylinder Volume (L)
/ Air consumption(L/min)
