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CCSF EMTP: 122 Pharmacology and Airway > Ch. 15 Airway Management > Flashcards

Ch. 15 Airway Management Flashcards

1
Q

Name 6 Indications for Endotracheal Intubation

A

Indications for ET Intubation:

  1. Respiratory or Cardiac arrest
  2. Prolonged unconsciousness / No gag reflex
  3. Risk of aspiration
  4. Obstruction due to foreign bodies, trauma, burns, anaphylaxis
  5. Respiratory extremis due to disease
  6. Pnuemothorax, hemothorax, hemo-pnuemothorax with repiratory difficulty
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2
Q

What are some complications of ET Intubation?

A

Complications of ET intubation:

  1. Esophogeal intubation
  2. Hypoxia
  3. Endobronchial intubation (right mainstem intubation)
  4. Tenion pneumothorax due to over ventilation
  5. Equipment malfunction
  6. Teeth breakage and soft tissue lacerations
  7. Hypoxia
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3
Q

How many inches do we raise the head for ideal positioning for ET intubation? What does it align?

A

By Ramping: 10 cm (4 inches) off the bed by placing a folded sheet or other object under the head.

This aligns the oral, pharyngeal and laryngeal axes into the “sniffing position”

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4
Q

Appropriate airway management:

  • Open and maintain _____ airway
  • Recognize and treat ____________
  • Assess ___________, and ____________ status
  • _______________ Oxygen
  • Provide _____________ assistance
A

Appropriate airway management:

  • Open and maintain Patent airway
  • Recognize and treat Obstruction
  • Assess Ventilation, and Oxygenation status
  • Administer Oxygen
  • Provide Venitatory assistance
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5
Q

Upper Airway: All ________ above the ________ ________.

A

Upper Airway: All structures above the Glottic Opening.

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6
Q

The _______ is the the first and largest anatomic structure. It must be manipulated and has a tendency to fall back into the ___________ _________ of unresponsive PTs.

A

The Tongue is the the first and largest anatomic structure. It must be manipulated and has a tendency to fall back into the Posterior Pharynx of unresponsive PTs.

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7
Q

The Pharynx is composed of the

__________

___________

_______________

A

The Pharynx is composed of the

Nasopharynx

Oropharynx

Laryngo(hypo)pharynx

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8
Q

___________ is the process of loading oxygen molecules onto hemoglobin molecules in the bloodstream.

A

Oxygenation is the process of loading oxygen molecules onto hemoglobin molecules in the bloodstream.

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9
Q

The LOWER AIRWAY extends from the _______ to the __________ ____________ _________.

A

The LOWER AIRWAY extends from the Glottis to the Pulmonary Capillary Membrane.

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10
Q

A method used to predict dificult intubation. A mouth opening of less that ____ fingerbreadths, a mandible length of less that _____ fingerbreadths, and a distance from the ______ ____ to the _______ ______ of less than ___ fingerbreadths to indicate a possibly difficult airway.

A

3-3-2 Rule: A method used to predict dificult intubation. A mouth opening of less that Three fingerbreadths, a mandible length of less that _____ fingerbreadths, and a distance from the ______ ____ to the _______ ______ of less than ___ fingerbreadths to indicate a possibly difficult airway.

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11
Q

Acetylcholine (ACh): A chemical neurotransmitter of the _________________ nervous system.

A

Acetylcholine (ACh): A chemical neurotransmitter of the Parasympathetic Nervous System.

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12
Q

An absence of oxygen.

A

Anoxia

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13
Q

Adventitous means…

A

Abnormal

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14
Q

The pressure gradient against which the heart must pump; an increase can decrease cardiac output.

A

Afterload

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15
Q

The inability to speak.

A

Aphonia

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16
Q

Slow, shallow, irregular respirations or occasional gasping breaths that result from crebral anoxia.

A

Agaonal Gasps

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17
Q

The continued alveolar uptake of oxygen, even when the patient is apneic; can be facilitated by administratering O2 via nasal cannula during intubation.

A

Apneic Oxygenation

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18
Q

Unequal movement of the two sides of the chest; indicates decreased airflow into one lung.

A

Asymetrical Chest Wall Movement

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19
Q

Prolonged gasping inspirations followed by extremely short, ineffective expirations; associated with brainstem insult.

A

Apneustic Respirations

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20
Q

Trauma resulting from excessive pressure.

A

Barotrauma

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21
Q 
\_\_\_\_\_\_\_\_\_-\_\_\_\_\_\_\_\_\_\_\_ drugs that provide muscle relaxation and mild sedation; include drugs such as Diazepam (Valium)
 and Midazolam (Verced).
A 
**Benzodiazepines:** **Sedative-Hypnotic** drugs that provide muscle relaxation and mild sedation; include drugs such as Diazepam (Valium)
 and Midazolam (Verced).
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22
Q

An effective technique to improve laryngoscopic view of the vocal chords by external manipulation of the larynx.

A

Bimanual Laryngoscopy

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23
Q

A form of non-invasive positive pressure ventilation that delivers two pressures (a higher inspiratory positive airway pressure and a lower expiratory positive airway pressure).

A

Bilevel Positive Airway Pressure (BPAP)

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24
Q

Irregular pattern, rate, and depth of respirations with intermittent periods of apnea; result from increased intracranial pressure.

A

Biot (ataxic) Respirations

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25
Q

An oxygen flowmeter that is commonly used because it is not affected by gravity and can be placed in any position.

A

Boudon-gauge Flowmeter

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26
Q

A combination of the tracheal and vesicular breath sounds; heard where airways and alveoli are found, the upper part of the sternum and between the scapulas.

A

Bronchovesicular Sounds

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27
Q

The backward, upward, and rightward pressure used during intubation to improve the laryngoscope view of the glottic opening and vocal cords; also called external laryngeal manipulation.

A

BURP Maneuver

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28
Q

A device that attaches between the endoracheal tube and the ventilation device; provides graphic information about the presence of exhaled carbon dioxide.

A

Capnographer

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29
Q

A device that performs the same function and attaches in the same way as the capnographer but provides a digital reading of the exhaled carbon dioxide.

A

Capnometer

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30
Q

A device that measures absorption at several wavelengths to distinguish oxyhemoglobin from carboxyhemoglobin.

A

Carbon Monoxide Oximeter

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31
Q

Hemoglobin loaded with carbon monoxide.

A

Carboxyhemoglobin (COHb)

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32
Q

A gradually increasing rate and depth of respirations followed by a gradual decrease with intermittent periods of apnea; associated with brainstem insult.

A

Cheyne-Stokes Respirations

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33
Q

A device that attches between the endotracheal tube and ventilation device; uses special paper that should turn from purple to yellow during exhalation, indicating the pressence of exhaled carbon dioxide.

A

Colormetric Carbon Dioxide Detector

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34
Q

A multilumen airway device that consists of a single tube with two lumens, two balloons, and two ventilation ports; an alternative device if endotracheal intubation is not possible or has failed.

A

Combitube

35
Q

A method of ventilation that delivers a single pressure, used primarily in the treatment of critically ill patients with respiratory distress; can prevent the need for endotracheal intubation.

A

Continuous Positive Airway Pressure (CPAP)

36
Q

A system used to predict intubation difficulty based on the airway structures observed suring laryngoscopy.

A

Cormack-Lehane classification

37
Q

The breath sounds produced as fluid-filled alveoli pop open under increasing inspiratory pressure; can be fine or coarse; formerly called rales.

A

Crackles

38
Q

Blue or purple skin; indicates inadequate oxygen in the blood.

A

Cyanosis

39
Q

A procedure in which a patient is sedated for the purpose of preoxygenation prior to the administration of a paralytic and intubation.

A

Delayed Sequence Intubation (DSI)

40
Q

The process of replacing nitrogen in the lungs with oxygen to maintain a normal oxygen saturation level during intubation

A

Denitrogenation

41
Q

A drug that competitively binds with the acetylcholine receptor sites but is not affected as quickly by acetylcholinesterase; an example is succinylcholine chloride.

A

Depolarizing neuromuscular blocker

42
Q

A method of intubation that involves directly palpating the glottic structures and elevating the epiglottis with the middle finger while guiding the endotracheal tube into the trachea by using the sense of touch.

A

Digital Intubation

43
Q

Visualization of the airway with a laryngoscope.

A

Direct Laryngoscopy

44
Q

A medication that distorts perception of sight and sound and induces a feeling of detachment from environment and self.

A

Dissociative Anesthetic

45
Q

Dysphonia means…

A

difficulty speaking.

46
Q

Difficult or labored breathing is called…

A

Dyspnea

47
Q

Inserting an endotracheal tube through the glottic opening and sealing the tube with a cuff inflated against the tracheal wall.

A

Endotracheal (ET) Intubation

48
Q

A leaf-shaped cartilaginous structure that closes over the trachea during swallowing.

A

Epiglottis

49
Q

Performing intubation at the same level as the patient’s face; used when the standard position is not possible. In this position, the laryngoscope is held in the provider’s right hand and the endotracheal tube in the left.

A

Face-to-face Intubation

50
Q

Brief, uncoordinated twitching of small muscle groups in the face, neck, trunk, and extremities; may be seen after the administration of a depolarizing neuromuscular blocking agent (succinylcholine chloride).

A

Fasciculations

51
Q

The enlargement or expansion of the stomach, often with air; can be a complication of ventilating the esophagus instead of the trachea.

A

Gastric Distention

52
Q

An automatic reaction when something touches an area deep in the oral cavity that helps protect the lower airway from aspiration.

A

Gag Reflex

53
Q

A flexible device that is inserted between the glottis under direct laryngoscopy; the endotracheal tube is threaded over the device, facilitating its entry into the trachea. Also called a tracheal tube introducer.

A

Gum Elastic Bougie

54
Q

Manual airway maneuver that involves tilting the head back while lifting up on the chin; used to open the airway of an unresponsive nontrauma patient.

A

Head Tilt–Chin Lift Maneuver

55
Q

An iron-containing protein within red blood cells that has the ability to combine with oxygen.

A

Hemoglobin

56
Q

Increased carbon dioxide content in arterial blood.

A

Hypercapnia

57
Q

A condition in which an increased amount of air enters the alveoli; carbon dioxide elimination exceeds carbon dioxide production.

A

Hyperventilation

58
Q

Decreased carbon dioxide content in arterial blood.

A

Hypocapnia

59
Q

A condition in which a decreased amount of air enters the alveoli; carbon dioxide production exceeds the body’s ability to eliminate it by ventilation.

A

Hypoventilation

60
Q

A decrease in arterial oxygen level.

A

Hypoxemia

61
Q

A lack of oxygen to cells and tissues.

A

Hypoxia

62
Q

A supraglottic airway device that uses a noninflatable, gel-like mask to isolate the larynx and facilitate ventilation.

A

I-Gel

63
Q

An expression for comparing the length of inspiration with that of expiration, normally 1:2, meaning that expiration is twice as long as inspiration (not measured in seconds).

A

Inspiratory/Expiratory (I/E) Ratio

64
Q

Bypassing of oxygen-poor blood past nonfunctional alveoli.

A

Intrapulmonary Shunting

65
Q

A technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used when a patient may have a cervical spine injury.

A

Head-Tilt Chin Lift Manuever

66
Q

A single-lumen airway that is blindly inserted into the esophagus; when properly placed in the esophagus, one cuff seals the esophagus, and the other seals the oropharynx.

A

King LT Airway

67
Q

A respiratory pattern characteristic of diabetic ketoacidosis, with marked hyperpnea and tachypnea; represents the body’s attempt to compensate for the acidosis.

A

Kussmaul respirations

68
Q

A device that surrounds the opening of the larynx with an inflatable silicone cuff positioned in the hypopharynx; an alternative to bag-mask ventilation.

A

Laryngeal Mask Airway (LMA)

69
Q

The ability of the alveoli to expand when air is drawn into the lungs during negative pressure ventilation or positive pressure ventilation.

A

Lung Compliance

70
Q

A special type of forceps that is curved, thus allowing paramedics to maneuver it in the airway.

A

Magill Forceps

71
Q

A system for predicting the relative difficulty of intubation based on the amount of oropharyngeal structures visible in an upright, seated patient who is fully able to open his or her mouth.

A

Mallampati Classification

72
Q

The chemical processes that provide the cells with energy from nutrients.

A

Metabolism

73
Q

A compound formed by oxidation of the iron on hemoglobin.

A

Methemoglobin (metHb)

74
Q

Airway device with a single long tube that can be used for esophageal obturation or endotracheal tube ventilation, depending on where the device comes to rest following blind positioning.

A

Multilumen Airway

75
Q

An opening on the side of an endotracheal tube at its distal tip that permits ventilation to occur even if the tip becomes occluded by blood, mucus, or the tracheal wall.

A

Murphy Eye

76
Q

A device that delivers oxygen via two small prongs that fit into the patient’s nostrils; with an oxygen flow rate of 1 to 6 L/min, an oxygen concentration of 24% to 44% can be delivered.

A

Nasal Cannula

77
Q

A soft rubber tube about 6 inches (15 cm) long that is inserted through the nose into the posterior pharynx behind the tongue, thereby allowing passage of air from the nose to the lower airway.

A

Nasopharyngeal (nasal) Airway

78
Q

Insertion of a 14-to 16-gauge over-the-needle intravenous catheter (such as an Angiocath) through the cricothyroid membrane and into the trachea.

A

Needle Cricothyrotomy

79
Q

Drawing of air into the lungs; airflow from a region of higher pressure (outside the body) to a region of lower pressure (the lungs); occurs during normal (unassisted) breathing.

A

Negative Pressure Ventilation

80
Q

Drugs that bind to acetylcholine receptor sites; they do not cause depolarization of the muscle fiber; examples are vecuronium (Norcuron) and pancuronium (Pavulon); also called paralytics.

A

Nondepolarizing Neuromuscular Blockers

81
Q

An emergency incision of the cricothyroid membrane with a scalpel and insertion of an endotracheal or a tracheostomy tube directly into the subglottic area of the trachea; also called surgical cricothyrotomy.

A

Open Cricothyrotomy

82
Q

A combination mask and reservoir bag system in which oxygen fills a reservoir bag attached to the mask by a one-way valve permitting a patient to inhale from the reservoir bag but not to exhale into it; at a flow rate of 15 L/min, it can deliver 90% to 100% inspired oxygen.

A

Nonrebreathing Mask

83
Q
A

CCSF EMTP: 122 Pharmacology and Airway (4 decks)

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