Basic Airway Management Flashcards
features that indicate inadequate ventilation
- unconscious patients causing the tongue to fall back and cause a temporary obstruction
- gurgling or raspy respirations also indicate patieal airway obstruction
- if the patient is not breathing at all
2 methods of removing the tongue as an obstruction in an unconscious person
- head til chin lift
2. jaw thurst
chin lift cannot be done in patients with suspected __ ___ injury
cervical spine injury. you should result to doing jaw thrust instead.
once you’ve done a jaw thust or head tilt chin lift, you should reassess patients breathing using the___ technique
the look listen and feel technique.
Look for foreign bodies in the mouth and for adequate rise and fall of the chest, listen for air movement at your patients’ mouth and feel for air movement on your face from the patient’s breathing.
when using a BVM:
- attach BVM unit to a __ LIter per minute O2 supply
- ensure your bags unit’s reservoir fills with oxygen
- using the E-C hand maneuver, provide __ -__ breaths per minute for most patients who are not breathing
- attach BVM unit to a 15 LIter per minute O2 supply
- ensure your bags unit’s reservoir fills with oxygen
- using the E-C hand maneuver, provide 10 -12 breaths per minute for most patients who are not breathing
what factors might make a BVM difficult to use
when patients have facial deformities, trauma, or beards.
- need to use two people: In the two person BVM technique, the first person uses both hands to form a seal with the mask and to lift the patient’s chin. The second person is dedicated to ventilating with the bag.
t/f you can also use an oropharyngeal airway in awake patients
false. One of the most utilized adjuncts for noninvasive ventilation is the oropharyngeal airway. This is a plastic device that is inserted into the patient’s oropharynx and serves to keep the tongue away from the posterior pharynx. Although this is a very useful tool, it should not be used in conscious patients as it can induce gagging and vomiting.
If your patient is unconscious, it is preferable to insert an ____ airway to improve BVM ventilation.
If your patient is unconscious, it is preferable to insert an OROPHARYNGEAL airway to improve BVM ventilation. Begin by selecting the correct size oropharyngeal airway. A correctly sized airway should go from the lips to the angle of the mandible.
how do you know that an oropharyngeal airway is well fitted?
A correctly sized airway should go from the lips to the angle of the mandible.
There are three clearly defined indications to perform endotracheal intubation. They are:
- Failure to oxygenate (SaO2<90%) (ex/ blockage)
- Failure to ventilate (ex/ COPD)
- Failure to protect the airway (ex/ alcohol intoxication, CNS disease)
For intubation, you will require the
following:
• An endotracheal tube: size 8 for most men, size 7.5 for most women.
• A 10 cc syringe to inflate the cuff on the ETT
• A stylet: this is used to help guide the tube and provides
some rigidity
• Lubricating jelly: to lubricate the end of the tube
• A laryngoscope: there are several types of blades, the
most common being the Macintosh curved blade
• Suction
• Securing tie / tape to secure endotracheal tube to patient
• A ventilator or bagging apparatus to attach the tube to.
• A rescue device such as larygneal mask (LMA ) or bougie
most common type of laryngoscopy
a Macintosh (“Mac 4 or Mac 5”)
outline some features in a person that would make intubation difficult
• Short neck • Small jaw • Poor jaw opening • Poor C-spine mobility • Big tongue • Prior surgery to the jaw/neck/mouth - MALLAMPATI CLASS: how much of the pharynx can be visualized when someone opens their mouth.
when you prepare for intubation, what should you make sure your patient has?
maximal preoxygenation. they should also be supine. What you want is to have your
patient in a position that will create a direct line of sight from the
mouth to the vocal cords.
In healthy young patients 3 minutes of pre-oxygenation with 100% O2 can provide sufficient stores to allow several minutes of apnea prior to desaturation. This margin of safety is smaller in the elderly and the very young, as well as in those who have underlying lung disease or large chest walls (i.e. obese patients) and large abdomens (pregnant patients).
in terms of patient positioning, how should their head be?
What you want is to have your
patient in a position that will create a direct line of sight from the mouth to the vocal cords.
The optimal position for the
patient is with the neck flexed forward and the head tilted slightly back. This is described as the “sniffing position” and can often be facilitated by placing a towel or small pillow under the patient’s head.
