CH 9 Airway Management

Question 1

Airway

Answer 1

The passageway by which air enters and leaves the body. The structures of the airway are the nose, mouth, pharynx, larynx, trachea, bronchi and lungs

Question 2

Patent airway

Answer 2

An airway (passage from nose or mouth to lungs) that is open and clear and will remain open and clear and will remain open and clear without interference to the passage of air into and out of the body

Question 3

Glottic opening

Answer 3

The level of the vocal cords that defines the boundary between the upper and lower airways

Question 4

Esophagus

Answer 4

Lies posterior to the Trachea

Question 5

Broncioles

Answer 5

Structures just proximal to the alveoli

Question 6

Brochoconstriction

Answer 6

The contraction of the smooth muscle in the bronchial passages

Question 7

The ___________ is the most common cause of airway obstruction

Answer 7

Tongue

Question 8

Bronchoconstriction

Answer 8

The contraction of smooth muscles that line the bronchial passages that results in a decreased internal diameter of the airway and increased resistance to airflow

Question 9

Stridor

Answer 9

A high pitched sound generated from partially obstructed airflow in the upper airway

Question 10

You approach a patient and speak with the patient. She says “Thank you for coming.” BASED ON THIS INFORMATION ONLY - What do you know about the status of her airway?

Answer 10

It is open, and she is capable of moving air right now

Question 11

Hoarseness

Answer 11

Can be indicative of a narrowing of the upper airway (especially if this is something that came on suddenly)

Question 12

Snoring

Answer 12

This is the sound of the soft tissue of the upper airway creating impedance (partial obstruction) to the flow of air to the patient

Question 13

Gurgling

Answer 13

The sound of fluid obstructing the airway

Question 14

You are at a restaurant and another patron in the restaurant suddenly jumps up and grasps their throat. You immediately ask if they can breath or speak. They just their head “no.” They appear unable to breath. Based on this information only, how would you identify their airway?

Answer 14

These are signs of an INADEQUATE airway

Question 15

What two questions do you want to ask yourself when assessing an airway?

Answer 15

1. Is their airway open? 2. Will their airway STAY open?

Question 16

Which of these patients has an open airway, but is still at risk for airway compromise? 1. A patient who overdosed on Opioids, his breathing WAS 4-6 BBM, we administered NARCAN, he is now A&O (can be x 1, 2, or 3) and now is breathing 16 BBM 2. A patient rescued from a structure fire, has facial burns, is coughing up black, sooty sputum. 3. A Patient who panicked in the swimming pool, swallowed water, was coughing, but is not coughing now and has good BBM 4. A patient who started to snore after falling asleep, but after you being called, and you making contact with the patient, they are annoyed, but A&O x 3

Answer 16

2. A patient rescued from a structure fire, has facial burns, is coughing up black, sooty sputum.

Question 17

Which of these patients has an open airway, but is still at risk for airway compromise 1. Patient who is talking clearly, but is hoarse and throat hurts after screaming for hours at a concert 2. A conscious patient with diminished lung sounds and nasal flaring 3. Patient who was complaining of tightness in cheat, but took Benadryl and now feels “ok” 4. Patient who took a drink of water, aspirated a little of it, choked, coughed and is no longer coughing

Answer 17

2. A conscious patient with diminished lung sounds and nasal flaring

Question 18

Your patient is a child with retractions, nasal flaring, and AMS. These are signs that the patient has what?

Answer 18

An inadequate airway

Question 19

As you listened to a patient’s chest, what would indicate an inadequate airway?

Answer 19

Diminished breath sounds

Question 20

When opening the airway of a patient what maneuver do you use?

Answer 20

Head Tilt, Chin Lift

Question 21

When opening the airway of a patient with suspected spinal injury, what maneuver would you use?

Answer 21

You use the jaw thrust maneuver

Question 22

For which of these patients would the head tilt, chin-lift maneuver be most appropriate to open the airway? 1. A​ conscious, alert adult who is talking in​ short, choppy sentences 2. An infant who is crying very loudly because of an earache 3. An adult who was found lying prone and bruised at the base of a stairway 4. An​ unconscious, adult overdose victim who was found in his bed

Answer 22

4. An​ unconscious, adult overdose victim who was found in his bed

Question 23

Head-tilt, Chin-lift Maneuver

Answer 23

A means of correcting blockage of the airway by the tongue by tilting the head back and lifting the chin. (Used when no trauma or injury is suspected)

Question 24

Jaw-Thrust Maneuver

Answer 24

A means of correcting blockage of the airway by moving the jaw forward without tilting the head or neck. Used when trauma or injury is suspected to open the airway without causing further injury injury to the spinal cord in the neck

Question 25

How do you clear a choking infants airway?

Answer 25

1. Pick up the infant, and supporting the infant in one hand and forearm, while also supporting the chin (head tilted lower than the body) 2. Do 5 back slaps with the palm of your hand (this is NOT the time to be gentle) 3. Put the child supine, and perform 5 chest thrusts Repeat as many times as necessary to clear the airway

Question 26

When sizing an NPA (Nasopharyngeal Airway), what is the proper way to conduct this measurement?

Answer 26

Measure from the tip of the patients nose to the tip of the earlobe (or angle of the jaw)

Question 27

Oropharyngeal Airway

Answer 27

A curved device inserted through the patients mouth into the pharynx to help maintain an open airway

Question 28

Nasopharyngeal Airway

Answer 28

A flexible breathing tube inserted through the patients nostril into the pharynx to help maintain an open airway

Question 29

Gag reflex

Answer 29

Vomiting or retching that results when something is placed in the back of the pharynx. This is tied to the swallow reflex

Question 30

When inserting an airway, what is something that you always want to ensure that you do (other than measuring the device)

Answer 30

Have suction ready in the case of the patient vomiting

Question 31

What technique would you use when inserting an OPA?

Answer 31

Crossed-finger technique

Question 32

How do you initially insert the OPA?

Answer 32

Insert the OPA facing the roof of the mouth

Question 33

You inserted the OPA as you have been taught. What is the next thing that you would do, and when would you do this part of the task?

Answer 33

After getting resistance from the soft palate, you will rotate the OPA from the “tip up” position, 180 degrees and then you will continue advancing the OPA until it rests on the lips of the patient

Question 34

After you have completed all of the steps of the OPA insertion, what would you do if the patient regains consciousness OR if a gag reflex is present?

Answer 34

REMOVE the OPA IMMEDIATELY (this is where your having the Suction present comes into play)

Question 35

The removal of a liquid foreign body from an airway would require WHAT adjunct?

Answer 35

Suctioning

Question 36

When suctioning a patient which of the following would not normally be needed? 1. Gown 2. Eye Protection 3. Gloves 4. Mask

Answer 36

1. Gown

Question 37

When should suction be applied to the catheter? 1. As you insert it and as you remove it 2. As you insert it 3. As you remove it 4. Before you insert it

Answer 37

3. As you remove it

Question 38

Suctioning

Answer 38

Use of a vacuum device to remove blood, vomitus, and other secretions or foreign materials from the airway

Question 39

What is the first rule of suctioning

Answer 39

Always use appropriate infection control techniques

Question 40

What is the second rule of suctioning

Answer 40

Limit suctioning to NO LONGER THAN 10 SECONDS AT A TIME

Question 41

What is the third rule of suctioning

Answer 41

Place the tip/catheter where you want to suction and suction on the way OUT

Question 42

When a collecting tube is clamped, a suctioning system must be able to generate no less than what? 1) 300 mmHg 2. 200 mmHg 3. 500 mmHg 4. 400 mmHg

Answer 42

1) 300 mmHg

Question 43

A proper technique of suctioning includes 1. Inserting the tip of the rigid catheter approximately 2 cm past the base of the tongue. 2. Inserting the catheter no farther than the base of the tongue. 3. Suctioning while inserting the catheter into the​ patient’s mouth. 4. Positioning yourself at the​ patient’s side.

Answer 43

2. Inserting the catheter no farther than the base of the tongue.

Question 44

Your patient has a skull fracture and it has caused brain tissue to be visible in the pharynx during your inspection of the patient’s airway. What type of special consideration and action would be needed in this case?

Answer 44

Suctioning should be limited to the mouth

Question 45

What large leaf-like object covers the glottic opening which seals off the trachea during swallowing or in response to a gag reflex

Answer 45

Epiglottis

Question 46

What should be done with dentures?

Answer 46

Leave them in place if at all possible. If there is a danger of them coming dislodged, then remove them

Question 47

What is the most important thing to consider when determining the need to suction

Answer 47

Constant observance of the patient

Question 48

During bronchoconstriction, the smooth muscles that line the bronchial passages contracts, resulting in a decrease of the internal diameter of the airway and an increase of

Answer 48

Resistance to airflow

Question 49

Carina

Answer 49

The branch in the bronchus where the bronchus splits to the left and right bronchioles

Question 50

Suctioning is used to correct 1. Stridor 2. Foreign body obstruction 3. Hypoxia 4. Fluid in the upper airway

Answer 50

4. Fluid in the upper airway

Question 51

When an infant is unconscious in bed, what procedure should the EMT use to open the airway?

Answer 51

Head-tilt, chin lift

Question 52

All of the following can result in airway obstructions except 1. facial trauma 2. infections 3. burns 4. the tongue

Answer 52

4. the tongue