Breathing assessment and airway emergencies - PACU

Question 1

Cause of quiet breathing

Answer 1

Normal

Question 2

cause of no sound

Answer 2

Complete airway obstruction

Question 3

cause of snoring

Answer 3

Tongue falling back in throat.

Question 4

cause of Bubbling and gurgling

Answer 4

Fluid, such as blood or vomit in throat

Question 5

cause of Crowing

Answer 5

Laryngospasm

Question 6

cause of Wheeze/whistling

Answer 6

Foreign body present, bronchospasm

Question 7

cause of Stridor

Answer 7

Vocal cord oedema after extubating, foreign body.

Question 8

Any fluid/foreign material in the mouth or pharynx should be removed by suction as it may:

Answer 8

• Obstruct the airway
• Irritate the larynx and cause laryngeal spasm
• Be inhaled into the lungs of laryngeal reflexes have not yet returned
• Provoke violent coughing spasms
• Avoid mucosal damage the wall suction unit should be set between 100-120mmHg.

Question 9

Indications of suction

Answer 9

• Any sound is heard during respiration
• Obvious secretions and or the patient begins to vomit
• Pt is failing to saturate well
• Any sign of airway obstruction.

Question 10

Managing airway patency - oropharyngeal airway

Answer 10

Most common is the guedel
- inserted to prevent the tongue falling back and obstructing breathing.
- check position to ensure the lips don’t come between teeth and airway as bleeding and swelling may occur.

Question 11

Managing airway patency - nasopharyngeal airway

Answer 11

• required if airway can’t be maintained by guedel
• jaws are clammed tightly
• jaws are wired together

Question 12

Laryngeal oedema - airway emergency

Answer 12

Feature of acute inflammation
- presents shortly after extubation
- common feature is post-extubation stridor
- results from damage to the mucosa of the larynx

Question 13

Laryngospasm - airway emergency

Answer 13

A sudden and violent contraction of the vocal cords that may result in complete or partial closure of the trachea.
- unable to speak or breathe