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Lab Lecture > AW Managment > Flashcards

AW Managment Flashcards

1
Q

Reasons for altered AW patency

A

CNS depression from O.D. or anesthesia

Cardiac arrest
Loss of consciousness
Sleep apnea

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2
Q

Loss of consciousness diminishes what reflexes?

A

Gag
Swallow
Laryngeal
Tracheal
Carinal

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3
Q

Etiology of upper AW obstruction? (part or complete blockage)

A

Posterior tongue block
Foreign matter
Allergic reaction
Infection
Anatomical abnormalities
Trauma

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4
Q

How to assess AW patency?

A

Speak to patient if awake (they will indicate)

If not awake, lack of breathing sounds, or chest rise

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5
Q

First step to successfully resuscitation?

A

Skillful AW management

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6
Q

Gold standard of securing AW?

A

Endotracheal tube

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7
Q

Steps to head tilt/ chin lift?

A

Stand at side of patient

Place palm on forehead

Place fingers under bony part of chin

Tilt head backward using palm while lifting chin

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8
Q

What do you use if you suspect a spinal cord injury?

A

Modified Jaw Thrust

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9
Q

Indication for manual resuscitation

A

Apnea
Cardiac arrest
Impaired cough
Uncontrolled secretions
Increase O2 tension
To facilitate suctioning
Hyper inflate lungs
Need to transport unstable or intubated pt.

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10
Q

What do you do before bagging?

A

Pull out reservoir

Attach to source on at least 15L/min

Select best size mask

Attach mask to bag

Occlude patient side

Squeeze bag and feel for resistance

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11
Q

What happens if a NPA is too short?

A

Fails to separate soft palate from tongue

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12
Q

What happens if NPA is too long?

A

Can enter vallecula and become occluded by soft tissue

Esophagus

Enter larynx and stimulate cough reflex

Can stimulate gag and vomit

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13
Q

Process of insertion of NPA?

A

Measure NPA

Lubricant with water-soluble lubricant

Position patient in sniff

Introduce NPA with bevel toward nasal septum

Advance until airflow is established (start with right)

Retract AW if it meets resistance

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14
Q

Steps to insert an OPA?

A

Remove foreign matter
Hyper-extend neck
Open mouth with cross finger technique
Insert AW with tip aimed up
Aw should reach uvula
Rotate 180
Rest flange at top of lip
Tamps if necessary

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15
Q

Complications of OPA?

A

Iatrogenic trauma and AW hyperactivity

Minor trauma of pinching lips and tongue (common)

Ulceration and necrosis of oropharyngeal form long-term contact (days)

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16
Q

Volume of air ventilated?

A

400-500 cc

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17
Q

How often should you ventilate?

A

Every 5-6 seconds (10/minutes)

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18
Q

What should rescuers do during resuscitation?

A

Watch chest rise

Periodically auscultation to ensure adequate ventilation

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19
Q

What are other necessary measurements to obtain during bag mask ventilation?

A

Pulse oximetry and capnography

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20
Q

What is a suction tip called?

A

Yankauer

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21
Q

What are the four types of manual resuscitators?

A

Self-inflating bag/valve/mask
Flow Inflating
T-Piece
Automatic

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22
Q

Signs that determine need for an artificial airway?

A

Upper respiratory obstruction or infection

Neuromuscular disease (particularly in crisis)

CNS damage

Pulmonary failure

Cardiac failure or insufficiency

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23
Q

Signs that indicate use for a supraglottic Aw?

A

Maintain airway

Allows administration of gases

Permit manual or mechanical ventilation

Used in controlled or emergency when
intubation cannot be done

Blind insertion (orally)

Temporary airway

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24
Q

Examples of a supraglottic Aw?

A

Laryngeal mask airway

Laryngeal tube airway

Combitube

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25
Q

Indications for Laryngeal tube insertion

A

Blindly inserted for emergency AW management

Can be first choice or backup

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26
Q

Hazard of the supraglottic Aw

A

Aspirations with conscious and unconscious patients (awake may gag)

Hypoventilation

Oropharyngeal mucosal injury

Injury to larynx, esophagus and related structures

Esophagus disease (strictures, varices)

Abnormal anatomy

Displacement of glottis

Moving head can move tube

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27
Q

What is the magill curve

A

A curve in endotracheal tube to conform to anatomy of airway (12-16 cm)

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28
Q

Description of endotracheal tube

A

Wide bore conduit

Can be placed through nose

Made of PVC (thermoplastic) initially rigid but warms to BT and become softer for comfort (polymeric silicone can also be used)

Has a radio opaque line for x-ray placement

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29
Q

Specific ETT for specific procedures?

A

Oral surgery: RAE tube
Lung surgery: a double lumen tube

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30
Q

When do we use ETTs

A

Artificial airway
Bypass oral cavity and pharynx

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31
Q

When do we place nasotracheal tubes?

A

Awake patient
Poor visualization
Oral cavity
Mobilization of neck contraindicated

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32
Q

Impact of ETT diameter

A

Larger tubes have less Aw resistance (easier to suction pass bronchoscope)

Larger tube increases damage

Inner diameter decreases with time (can be critical at starts 24hrs after intubation)

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33
Q

Inner diameter of endotracheal tube?

A

Goes up by 0.5 mm (2.5-10mm)

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34
Q

Usual size of ETT by gender?

A

Females: 7-8 mm

Males: 8-9 mm

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35
Q

The four types of manual resuscitation?

A

The self-inflating bag/valve/mask
Flow inflating
T-piece
Automatic

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36
Q

Features on the BMV

A

Pressure relief bag w/ mechanisms to override

A pressure-sampling port to allow monitoring PIP

Exhalation valve has a splash guard (boops and secretions)

Exhalation valve can help deliver PEEP

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37
Q

Function of BMV

A

Smooth-bore oxygen tubing carries O2 from source

One-way valve at O2 inlet

When the bag is squeezed, one way valve near patient opens and near inlet closes

Fresh O2 flow is diverted to a tail at rear

Exhaled gas flows from mask out an additional one-way valve

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38
Q

BMV inner and outer diameter

A

A standard 15 mm internal diameter fits on endotracheal tube 22 mm external diameter slips in mask

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39
Q

Application for self-inflating BVM

A

Adult respiratory care
Medication installation
Aerosolized medication delivery

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40
Q

What influences the FiO2 delivery through a manual resuscitator?

A

Correct seal
O2 flow rate
Reservoir
BVM should deliver close to 100 FiO2
Stroke volume
Refill time
RR

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41
Q

When is breath delivered for the breathing patient?

A

When the pressure drop is felt/ pressure triggered

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42
Q

When is a breath delivered with the apeanic patient?

A

Time triggered (5-6 seconds)

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43
Q

Assessing appropriate breath delivery?

A

Chest rise
Look for condensation in mask
Listen for leaks
Watch for gastric distention
End-tidal CO2

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44
Q

Effects of poor bagging technique?

A

High RR age stroke volume can decrease venous return to heart

Pressure greater than 25cmH2O can cause gastric insufflation

If against spontaneous breaths can work against the patient

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45
Q

Trouble shooting BMV problems?

A

A substantial decrease in pressure to deflate bag can suggest O2 inlet valve failure

If patient cannot exhale, non-rebreathing valve may be broke or jammed

Sudden lose in resistance suggest pressure sampling port has popped open

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46
Q

Hazards of BVM?

A

Hypoxia
Equipment failure
Poor technique
Cross-contamination
Difficult or impossible to measure VT
Difficult or impossible to measure pressure
FiO2 can’t be measured

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47
Q

Contradictions for BVM

A

Awake intolerant patients
Untreated pneumothorax
Facial trauma
Total upper Aw obstruction
Should be guided by the type of Aw available and patient needs

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48
Q

cons of the Automatic resuscitators

A

Lacks consistency, sophistication in delivery, and alarm function

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49
Q

Can you set the maximum pressure for the O2 powered demand valve resuscitator

A

Yes

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50
Q

Is the Demand-valve resuscitation a one hand device

A

Allows two-handed mask seal

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51
Q

Reasons you wouldn’t perform resuscitators?

A

Patient had (do not intubate)

Resuscitation has been deemed to be futile

Resuscitation can be dangerous to rescuer

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52
Q

Does the flow inflating resuscitators non-rebreathing valve close during inspiration or expiration

A

Lack non-rebreathing mask

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53
Q

Coordinating tasks needed with flow inflating resuscitators

A

Adjust gas source

Control outflow resistance from bag through flow control valve to regulate CPAP

Control force of manual compression of the bag

Maintain proper seal

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54
Q

Application for flow inflating resuscitators?

A

Operating room
Delivery room
Neonatal intensive care
Not often with adults

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55
Q

T-piece resuscitator flow range

A

Compressed gas source delivers 5-15 L/m

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56
Q

Equipment for an intubation?

A

Laryngoscope
ETT
Stylet
Syringe
Suction catheter
CO2 detector
OPA
NPA
Bag-valve-mask
Nasal cannula

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57
Q

Laryngoscopes use?

A

Visualize larynx for diagnostic, procedure, therapeutic intervention

Most common: secure Aw

3 components: handle, blade, light source

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58
Q

Benefit of pen light /slender handle?

A

Improve balance for smaller blades

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59
Q

Benefit of the stubby handle?

A

Thicker and shorter for patients with thick necks or barrel chest

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60
Q

Benefits of large handles?

A

Used for larger patients

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61
Q

Benefits of adjustable handle?

A

Can be positioned for patients with cervical spine injury, halo traction, and obesity

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62
Q

Use for the Oxford blade?

A

Neonates, infantes, and children

Helps with cleft palate

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63
Q

Macintosh blade design?

A

Used for adults

Reverse “z” shape

Variety of flange styles:
Shape
Height
Light position
Light type

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64
Q

Miller usage?

A

Adults- infants with flexible Aw

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65
Q

Factors of hard intubation that video laryngeal scope is used for?

A

Restricted oropharyngeal
Blood/secretions in Aw
Cervical spine immobilization
Obesity

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66
Q

What is the lighted stylet used for?

A

Blind
Awake
Laryngo-scope assisted intubation

Lubricant light wand before

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67
Q

Design for the Bougie stylet?

A

Blunt ended malleable wand and twice the length of the ETT

(Contradicted by children less than 8)

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68
Q

What are tube exchangers?

A

Semi rigid tube with O2 hole

Marked by depth and used to exchange ETT without laryngoscope

Used when ETT fails

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69
Q

What flow does the demand valve deliver

A

Constant 30Lpm

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70
Q

How many mLs does the demand valve resuscitator deliver

A

500 mL

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71
Q

Is the RR automatically set on the demand valve resuscitator

A

No, it can be set or manually triggered by a button

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72
Q

How does the Demand-valve resuscitation device prevent GI distension

A

You can limit the pressure delivery

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73
Q

What were the flaws of the older Demand-valve resuscitation device

A

Many of them were reported for malfunctioning

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74
Q

Where is the Demand-valve resuscitation device used

A

Mostly military, rescue and EMS circumstance

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75
Q

Who strongly favors the Demand-valve resuscitation device

A

Emergency medicine physician

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76
Q

Diameter of the flow inflating resuscitators mask connector

A

Has 15 mm inner diameter and 22 mm outer

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77
Q

What feature of the flow inflating resuscitators that allows the RT to bag, assess

A

Designed in a 90 degree angle so RT can bag standing next to them or at head of bed

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78
Q

How does the flow inflating resuscitators flow control valve regulate flow

A

Flow control valve regulates resistance (NOT flow, source regulates)

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79
Q

What happens if the flow going to the bag isn’t great than the patients VT (flow inflating resuscitators)

A

The bag will collapse

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80
Q

What does the pressure manometer display

A

Peak inspiratory pressure

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81
Q

What does a Anesthesia bag do

A

Has a medication port for med delivery to tracheal airway ( if patient is intubated)

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82
Q

What feature does the flow inflating resuscitators have to prevent too much pressure reaching patient

A

Pressure pop off valve

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83
Q

What do experiences practitioners think about the mapleson bag

A

They find it sensitive to changes in patient compliance

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84
Q

Who mostly operates the mapleson bag

A

Anesthesiologist
(Properly trained practitioners)

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85
Q

What population is the mapleson bag usually used on

A

Neonates and infantes

86
Q

What T-piece resuscitator is used for infants

A

Neopuff

87
Q

What powers and who operates the T-piece resuscitators

A

Gas powered
Manually operated

88
Q

How does the T-piece resuscitators deliver flow and pressure

A

Provides ventilation at a set flow and delivers consistent PIP

89
Q

What allows adjustment of inspiratory pressure using T-piece resuscitators

A

Incoming gas flows through spring loaded valve that allows adjustable PIP

90
Q

Where is inspiratory pressure displayed on a T-piece resuscitator

A

Manometer

91
Q

Do you need a humidifier for the T-piece resuscitators

A

No, you can use a non humidified circuit

92
Q

What interface can you use with the T-piece resuscitator

A

Mask and endotracheal tube

93
Q

Does the automatic resuscitator need to be tethered

A

Provides ventilation w/o being tethered to device

94
Q

Automatic resuscitator use

A

Used for transport or emergencies

95
Q

Benefits of the automatic resuscitator

A

Easy setup, little time, expedites transport

May improve compression to ventilation

96
Q

What does “lemon” stand for

A

Look
Evaluate
Mallampati
Obstruction
Neck

97
Q

Aspects of “look”

A

Trauma
Facial hair
Neck mass
Large tongue
Dentures

98
Q

Aspects of “evaluation” (3-3-2)

A

<3 fingers between incisors
<3 between hyoid and mental
2 fingers between hyoid and tracheal cartilage
(Difficult air way)

99
Q

Aspects of “mallampati”

A

Equal or greater than 3 is difficult

100
Q

Aspects of “Obstruction”

A

Obstruction or obesity restricts visualization

101
Q

Aspects of “neck”

A

Mobility and any restriction can cause difficulty passing

102
Q

Positioning of head for intubation

A

Sniffing

103
Q

How do you properly position patient for intubation

A

Elevated head
Extend head at neck
Align ears horizontally with sternal notch

104
Q

Positioning the head of obese patients

A

Rolls can be utilized to elevate head
External auditory meatus is aligns with sternal notch

105
Q

Minimal size required for bronchoscopy

A

7.5 mm

106
Q

What angle does the stylet create proximal to the cuff

A

35 degrees

107
Q

What is rapid sequence intubation (RSI)

A

Utilization of fast acting and short lived medication.

(Enhances chance of first pass success w/o aspiration)

108
Q

What is the time period of RSI medication administration

A

<30 seconds (minimize time of apnea)

109
Q

Medications used during RSI

A

Etomidate-sedative
Succinylcholine or rocuronium-paralytic

110
Q

Goal of pre-oxygenation

A

Slow down the decline of Oxy-Hemoglobin

111
Q

Preferred device for pre-oxygenation

A

Non-rebreather

112
Q

Benefits of tracheotomy tube over endo

A

Endotracheal tube may not be used long-term

Patient can be taken off ventilator

Reduced risk of infection

Reduces need for sedation

Patient can talk and eat

113
Q

Different material that can be used to make tracheostomy

A

Plastic
Silicone
Nylon
Metal

114
Q

What’s unique about the silicone tracheostomy

A

Bivona: Does not need an inner cannula

115
Q

Difference between nylon and metal tracheostomy

A

Not fenestrated
useful in decannulation process or ambulatory setting

116
Q

Can you still get a metal tracheostomy

A

Yes, reusable, and customizable
May be fenestrated

117
Q

Problem with metal tracheostomy

A

Ridged, flange angle is fixed, lacks 15 mm connector.

118
Q

Parts of a tracheostomy tube

A

Flange
outer cannula
Cuff inflating line
Cuff
Pilot ballon
Inner cannula
Obturator

119
Q

What does the pilot ballon do

A

Allows positive pressure ventilation and prevents aspiration

120
Q

Function of the uncuffed tracheostomy

A

Maintain patency of stoma

Patients that don’t need mechanical ventilation

121
Q

What does uncuffed tracheostomy do

A

Allow mechanical ventilation
Protect against aspiration

122
Q

Patients that usually have uncuffed tracheostomy

A

Children and weaning

123
Q

Function of tight to shaft tube

A

Mechanical ventilation and or minimize aspiration, while maximizing airflow
(Patients who need short term cuff inflation)

Expanded with sterile water (saline crystallize)

124
Q

Benefits of foam cuff

A

Reduces pressure against the tracheal wall

125
Q

Function of the foam cuff

A

Inserted after removing air from silicone cuff, allowing foam to collapse against outer cannula

After inserted pilot ballon port is open and cuff re-expands

126
Q

Indication for a proximal tube

A

Thick necks

127
Q

Indication for a distal tube

A

Long neck
Damage
(May have an adjustable flange)

128
Q

Fenestrated trach capping hazard

A

When fenestrated excessive airflow resistance can occur

An unfenestrated inner cannula will suffocate the patient

129
Q

What does the cuff have to look like to allow patients to speak

A

It has to be inflated

130
Q

Indication for talking trach tube

A

Patients with vocal cord but need mechanical ventilation

131
Q

How many liter go through the 1-several openings above the cuff to allow talking

A

4-6L/min

132
Q

Where does air go to allow talking

A

Tubing port is occluded, and air goes to larynx allowing speech

133
Q

First step before using a laryngoscope

A

Confirm light source is functioning and blade is locked in place

134
Q

What side of the mouth and what angle do you slide in the laryngoscope

A

On the right side of the patients mouth

45 degree angle against the tongue

135
Q

Which way do you push the tongue

A

Toward the left side of the mouth

136
Q

Where do you insert a straight blade

A

Down the midline to reach the epiglottis

137
Q

What does a straight blade lift

A

The mandible, tongue, and epiglottis as a unit

138
Q

What kind of stylet and blade does a video laryngoscope use

A

A curved blade
A ridged stylet

139
Q

What should you use if your first attempt at intubation is unsuccessful

A

A bougie:

A flexible device with an anteriorly angulated tip when VC are hard to see.

140
Q

What does the introduction of the bougie allow

A

Indirect identification of cartilaginous ridges of anterior airway

141
Q

When would you use a bougie first

A

If you anticipate a difficult airway

142
Q

How many “cc”s is the syringe filled with air

A

5-10cc

143
Q

Desired depth of distal tip of tube in women

A

19-21

144
Q

Desired depth of distal tip in men

A

21-23

145
Q

What will the extratracheal carbon dioxide waveform read

A

“0”

146
Q

How far should the distal tip of the endotracheal tube be from the carina

A

2-6cm

147
Q

What does the endotracheal tubes CO2 correlate with

A

Arterial partial pressure

148
Q

What is the tracheal capillary perfusion pressure

A

25-35mmHg

149
Q

What does low cuff pressure cause

A

Contributes to aspiration

150
Q

Kettering’s cuff recommended pressure in cm H2O and mmHg

A

25-35 cm H2O

20-25 mmHg

151
Q

What is the minimal occlusive volume technique (MOVT)

A

Air is added to a cuff to create a seal, so there is no leaks during inspiration

152
Q

What is the Minimum Leak Technique

A

Just enough air is removed from cuff to allow a small leak during inspiration to test patency

153
Q

Manual pressure test

A

Pilot ballon is gently pressed to estimate appropriate cuff pressure (subjective)

154
Q

What is the most accurate way to test cuff pressure

A

A device is used

155
Q

What happens if cuff pressure is too high

A

Mucosal damage can occur (ischemia/ decreased perfusion)

156
Q

Hazard of low cuff pressure other than dislodging

A

Supraglottic content can enter the airway(oral and stomach)

157
Q

Hazard of intubation

A

Mucosal or structural injury

Sympathies response (HR, BP, bronchospasm and laryngospasm)

Tube obstructed with secretions

Tube kink

Over, under, or uneven cuff

Vent associated pneumonia (VAP)

158
Q

What do we assess before extubation

A

Original problem
Quantity and thickness of secretions
Upper Aw pantency
Intact gag
Able to clear secretions
Can breath without invasive ventilator

159
Q

Steps for extubation

A

Assemble needed equipment
Suction
Oxygenate patient
Deflate cuff and listen
Remove tube
Apply oxygen with humidity/cool mist
Asses and reassess patient
(Good movement during auscultation)

160
Q

How does subglottic or above the cuff suctioning work

A

Cuffed tube with an opening above the cuff. The opening is attached to the suction

161
Q

Where do the arms go for the Montgomery T-Tubes

A

One arm goes to the trachea and the other goes to the subglottic space

162
Q

Where do the Montgomery T-Tubes provide support

A

Stenotic airway (tracheal stenosis, tracheomalacia, reconstruction)

163
Q

What size adapter is available for the Montgomery

A

15mm

164
Q

Is the cuff inflated with the speaking valve

A

No, it allows air to enter via upper airway and trachea

165
Q

During exhalation what happens to the speaking valves

A

Valves close or increases resistance redirecting air toward the larynx

166
Q

What about the patient would contradict the speaking valves

A

Unconscious
Unstable respiratory status
Large amount of secretions
High O2 requirement

167
Q

What kind of valves are most of the diaphragm speaking valves

A

Flapper valves

168
Q

How does the flapper bias closed valve work

A

Closed except during inspiration when tracheal negative pressure opens valve

(May have more air loss affecting speech quality)

169
Q

How does bias open valve work

A

Always open except during expiration
(May requires greater effort to achieve airflow)

When speaking valve used trach tube shouldn’t be 2/3 size of airway

170
Q

How do the passkey valves work

A

Closed bias

171
Q

What type of speaking valves is the Shirley speaking valve

A

Flappy valves

172
Q

What are Tracie phone assist speaking valves

A

Unidirectional diaphragm valve

173
Q

What are Shikani-French speaking valve

A

Ball valve design

174
Q

What are trach buttons

A

Used to wean patients some w/ inner cannulas or caps that allow occlusion

175
Q

Describe the trach buttons shape of

A

Straight, rigid, or hollow cannula that latches between skin and anterior wall of trachea

176
Q

Proper care of trach tube

A

Secure
Provide means for communication
Ensure adequate humidification
Minimize nosocomial infection
Facilitate secretion clearance
Provide cuff care
Troubleshoot airway problems

177
Q

Tracheostomy tube care (think check-off)

A

Assemble and check equipment
Explain procedure
Suction
Remove and clean inner cannula
Clean and examine site
Change tie/holder
Clean or replace cannula
Reassess patient

178
Q

Hazards off tracheostomy care

A

Hypoxia
Dyspnea
Bleeding
Decannulation

179
Q

Early complication with artificial airway

A

Laryngeal lesion
MOST COMMON:
Glottic edema
Vocal cord inflammation
Laryngeal/ vocal cord ulceration
Vocal cord polyps or granulomas

180
Q

What are the less common but serious early artificial airway complications

A

Vocal cord paralysis and stenosis

181
Q

Late complication with artificial airway

A

Granulomas
Tracheomalacia
Tracheal stenosis
Tracheoesophageal
Tracheoinnominate artery fistula

182
Q

Procedure of decannulation (weaning process)

A

Fenestrated tube
Progressively smaller tube
Tracheostomy button
Remove trach

183
Q

Assessing for decannulation

A

Original problem gone
Quantity and thickness of secretions
Upper airway patency
Intact gag reflex
Ability to clear secretions
Can sustain breathing

184
Q

What kind of pressure does suction use

A

Negative pressure

185
Q

What anatomy can suction be preform on

A

Oropharynx
Trachea
Mainstem Bronchi

186
Q

Should you do tracheal suction through the mouth

A

No, it can cause gagging

187
Q

Parts of the suction catheter

A

Tip
Catheter
Thumb-control valve
Handle
Connector for vacuum

188
Q

Reasons respiratory therapist could consider preforming suctioning

A

Maintain patent airway
Specimen collection
Stimulate cough
Remove secretions
Clear obstructed airways
Patient was a depressed cough
Loss of airway reflexes

189
Q

Suction pressure for adults

A

Less than 200mmHg (torr)

190
Q

Suction pressure for neonates

A

Less than 120 mmHg (torr)

191
Q

Explain a open suction

A

A sterile process that requires patient to be disconnected from the ventilator

192
Q

Explain a closed suction

A

A sterile process that can be done while the patient is attached to the ventilator

193
Q

First step in suctioning

A

Never do suction because of a schedule

Assess: breath sounds (coarse crackles)

194
Q

Second step in suctioning (assemble and check)

A

Select size

External diameter should be not more than half of internal artificial airway

195
Q

Formula for sizing catheter

A

Size x 3/2 = proper size

196
Q

Third step for suctioning (oxygen)

A

Hyper-oxygenate patient

100% for 30-60 seconds (pediatric-adults)

10% neonates

197
Q

Fourth step for suctioning

A

Insert catheter

198
Q

Fifth step in suctioning

A

Suction for <15 seconds

199
Q

Sixth step in suctioning

A

Re-oxygenate

200
Q

Last step in suctioning

A

Monitor patient and assess outcomes

201
Q

Who gets nasotracheal suction

A

Patients who do not have artificial airway

202
Q

What position do patients assume to perform nasotracheal suction

A

Sniffing

203
Q

What are non-hypoxia concerns when preforming nasotracheal suction and how do we avoid them

A

Gaging and regurgitation

Don’t preform immediately after meals

204
Q

What do we do if patients have adverse effects of nasotracheal suction

A

Prepare to reposition and suction oropharynx

205
Q

What does positioning in the sniffing position do

A

Aligns opening of the larynx with the lower pharynx

206
Q

Advantages and function of the whistle tip catheter

A

Extra holes for pressure relief

Extra holes also minimize risk of biopsy

207
Q

Advantages and function of Coude directional tip catheter

A

Extra holes for pressure relief

Extra holes minimize risk of biopsy

Could be directed toward right or left main stem using radiopaque line

208
Q

Advantages and function of Aeroflot catheter tip

A

Tube for bronchial suction with a traumatic ring tip

One central hole and four side holes to protect mucosa from invagination and trauma

Uniformly distributed flow

209
Q

Why use continuous suction vs intermittent suction

A

Continuous while withdrawing provides more efficient removal of secretions

210
Q

How to avoid hypoxia during suctioning

A

Oxygenate before, during and after

211
Q

How do you avoid atelectasis during suctioning

A

Limit negative pressure
Minimize suction time
Use appropriate sized suction
Avoid disconnecting from ventilator

212
Q

How to minimize water based complications from suctioning

A

Don’t regularly use normal saline into artificial airway prior to suction.

Only use if needed to mobilize thick secretions

Lab Lecture (5 decks)

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