Artificial Airways Flashcards
Why are artificial airways used?
WILL BE ON EXAM
to maintain patency of airway so air can flow in to and out of the lungs
What are the 4 types of airways?
- oropharyngeal
- nasopharyngeal
- endotracheal
- tracheostomy
In what circumstances would an artificial airway be needed?
if the pt is unconscious, head injury, overdose, general anesthesia, etc.
Which airway would be used when the pt is unconscious and their tongue is blocking the airway?
oropharyngeal
When would you NOT use an oropharyngeal airway?
in a conscious or semi-conscious person as it could stimulate the gag reflex resulting in vomiting and a potentially obstructed airway
How do you insert an oropharyngeal airway?
insert with the distal end curved upward along the top of the tongue then rotate 180 degrees once the airway reaches the soft palate at the back of the throat then slip airway past uvula into oral pharynx
Should you tape an oropharyngeal airway in place?
NO– you want them to spit it out as they wake up
How do you measure an oropharyngeal airway?
measure from the corner of the mouth to the angle of the jaw
When would you use a nasopharyngeal airway?
when the pt is conscious because it has a lower likelihood of inducing gag reflex as it is inserted into the nose
How do you determine the size of a nasopharyngeal airway?
measure from the tip of nose to earlobe and slightly smaller than the nares– the diameter of the trumpet should be approx. the same as pts little finger
NOTE: if the trumpet is too tight it can prevent drainage of sinuses and lead to infection
When is a nasopharyngeal airway contraindicated?
in pts with severe head or facial injuries or ave evidence of basilar skull fracture due to the possibility of direct intrusion upon brain tissue– raccoon eyes and/or cerebrospinal fluid leaking from ears or nose
What is the process of inserting an endotracheal tube called?
tracheal intubation– usually just called intubation
What are the indications for using an endotracheal tube?
upper airway obstruction (burns, tumour, bleeding), apnea (MI), high risk of aspiration, respiratory distress, and ineffective clearance of secretions
Are pts able to speak when intubated?
NO– the ETT passes through the epiglottis and glottis so they can’t speak or call for help when they need it!
What is the term for removing an endotracheal tube?
extubation
When is a tracheostomy appropriate?
when a pt needs long term airway support or to bypass upper airway
What is a tracheostomy?
surgical opening in the trachea just below the larynx
What are the advantages of a tracheostomy compared to an endotracheal tube?
-pt comfort
-pt able to talk (with adaptive device of add on speaking valve)
-improved management of secretions
-potential to wean from the ventilator
-trach tube is more secure, giving more mobility
