Chap 9 Flashcards
OPA
Oropharyngeal
Proper way to insert OPA in infant or child
Use a tongue depressor and slide OPA straight in versus the 180 degree method
Lower airway
Below the larynx and is composed of the trachea, bronchial passages and the alveoli
What happens when you put the yankauer to far down the pharynx
It might hit the vagus nerve in the back of the pharynx which can slow the heart rate
Acute vs Chronic airway problems
Acute- Foreign bodies, blood, vomit
Chronic- Usually lower airway (Bronchitis)
Airway primary assessment
- Is the airway open?
- Is the patient able to speak?
- Look
- Listen
- Feel
- Will the airway stay open?
- Are there potential threats that may develop later?
Anatomic children considerations
- Mouth and nose are smaller
- tongues are proportionally bigger
- trachea is softer and more flexible
- trachea is narrower and easily obstructed by swelling
- chest wall is softer which makes them depend more on diaphragm breathing
- infants require neutral neck position
- children slight extension of the neck
- use a rigid tip for children and infants
Rigid pharyngeal tip (suction tip)
Yankauer,
tonsil sucker
Tonsil tip suction
Airway blockage signs
Gurgling gasping crowing wheezing snoring stridor Inability to talk
Techniques of suction
Appropriate PPE No longer than 10 secs(causes hypoxia) Don’t put in farther than you can see Suction on the way out Suction is best on your side
Sniffing position
upright position with their head pitched forward as if they were attempting to smell something
Different parts of a suction machine
Tubing
suction tip or catheters,
collection containers
Container of clean or sterile water
laryngopharynx (hypopharynx)
the structure surrounding the entrance to the trachea
Stridor
high-pitched sound generated from partially obstructed airflow in the upper airway
NPA
Nasopharyngeal
bronchoconstriction or bronchospasm
- the contraction of the smooth muscle that lines the bronchial passages that result in a decreased internal diameter of the airway and increased resistance to airflow
- Ex. Asthma
2 different ways of opening airway
- Head-tilt, chin-lift
- Jaw-thrust
Special considerations for suction
- Facial injuries
- Suction for blood might need to be frequent
- Obstructions
- Objects to big for suction might need manual removal
- Dental appliances
- Leave in place unless it endangers airway
Carina
trachea branches at the carina and forms two main-stem bronchi
Nasal Flaring
widening of the nostrils of the nose with respirations. May be present, especially in infants and children
Gag reflex
vomiting or retching that results when something is placed in the back of the pharynx. This is tied to shallow reflex
Two ways to measure adjuncts
- Corner of the patients mouth to the tip of the earlobe
- center of the patients mouth to the angle of the lower jaw bone
2 important considerations of assessing airways
“Is the airway open”? and “will the airway stay open”?
Retractions
Children have a pulling in of the muscles above the clavicles and between and below the ribs
Rules for using a Airway adjunct
-No gag reflex
-Open the patients airway manually
-Don’t push tongue in with adjunct
-Have suction ready prior to inserting adjunct
-If patient regains consciousness or develops a gag reflex, remove adjunct
-Maintain head-tilt, chin-lift or jaw thrust while adjunct is in place
Use infection control practices
Suction system minimums
at least 30 liters a minute air intake and vacuum no less than 300mmHg when the tube is clamped
Flexible suction catheter sizes
French, larger the number, larger the catheter
