Chapter 15 Airway Management Flashcards
3-3-2 rule
A method used to predict difficult intubation.
A mouth opening of less than three fingerbreadths, a mandible length of less than three fingerbreadths, and a distance from hyoid bone to thyroid notch of less than two fingerbreadths indicate a possibly difficult airway
Abdominal thrust maneuver
Abdominal thrusts performed to relieve a foreign body airway obstruction.
Accessory muscles
The muscles not normally used during normal breathing; include the sternocleidomastoid muscles of the neck, the pectoral is major muscles of the chest, and the abdominal muscles.
Acetylcholine (ACh)
A chemical neurotransmitter of the parasympathetic nervous system.
Adventitious
Abnormal
after load
The pressure gradient against which the heart must pump; an increase can decrease cardiac output.
Atonal gasps
Slow, shallow, irregular respirations or occasional gasping breaths that result from cerebral anoxia.
anoxia
An absence of oxygen .
Anterograde amnesia
An inability to remember events after the onset of amnesia.
Aphonia
The inability to speak
Apneic oxygenation
The continued alveolar uptake of oxygen, even when the patient is apneic; can be facilitated by administering oxygen via nasal cannula during intubation.
Apneustic respirations
Prolonged gasping inspirations followeed by extremely short, ineffective expirations; associated with brainstem insult.
Asymmetric chest wall movement
Unequal movement of the two sides of the chest; indicates decreased airflow into one lung.
Automatic transport ventilator (ATV)
A portable mechanical ventilator attached to a control box that allows the variables of ventilation (such as rate and tidal volume) to be set.
Bag-mask device
A manual ventilation device that consists of a bag, mask, reservoir, and oxygen inlet; capable of delivering up to 100% oxygen.
Barotrauma
Trauma resulting from excessive pressure.
Benzodiazepines
Sedative-hypnotic drugs that provide muscle relaxation and mild sedation; include drugs such as diazepam (Valium) and midazolam (versed)
Biannual laryngoscopy
An effective technique to improve laryngoscopy view of the vocal cords by external manipulation of the larynx.
Bilevel positive airway pressure (BPAP)
A form of noninvasive positive pressure ventilation that delivers two pressures (a higher inspirations positive airway pressure, and a lower exploratory positive airway pressure).
Biot (ataxic) respirations
Irregular pattern, rate, and depth of respirations with intermittent periods of apnea; result from increased intracranial pressure.
Bourdon-gauge flowmeter
An oxygen flowmeter that is commonly used because it is not affected by gravity and can be placed in any position.
Bronchovesicular sounds
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.
BURP maneuver
The backward, upward, and rightward pressure used during intubation to improve the laryngoscopic view of the glottis opening and vocal cords; also called external laryngeal manipulation.
capnographer
A device that attaches between the endotracheal tube and ventilation device; provides graphic information about the presence of exhaled carbon dioxide.
Capnometer
A device that performs the same function and attaches in the same way as a capnographer but provides a digital reading of the exhaled carbon dioxide.
Carbon monoxide oximeter
a device that measures absorption at several wavelengths to distinguish oxyhemoglobin from carboxyhemoglobin.
carboxyhemoglobin (COHb)
Hemoglobin loaded with carbon monoxide
Cheyne- Stokes respirations
A gradually increasing rate and depth of respirations followed by a gradual decrease with intermittent periods of apnea; associated with brainstem insult.
Cobra perilaryngeal airway (CobraPLA)
A supraglottic airway device with a shape that allows the device to slide easily along the hard palate and to hold the soft tissue away from the laryngeal inlet.
Colorimetric carbon dioxide detector
A device that attaches between the endotracheal tube and ventilation device; uses special paper that should turn from purple to yellow during exhalation, indicating the presence of exhaled carbon dioxide.
Combo tube
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.
Continuous positive airway pressure (CPAP)
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.
Cormack- Lehane classification
A system used to predict intubation difficulty based on the airway structures observed during laryngoscopy
Crackles
The breath sounds produced as fluid-filled alveoli pop open under increasing inspiratory pressure; can be fine or coarse; formerly called rales.
Curved laryngoscopes blade
A blade designed to fit into the vallecula, indirectly lifting the epiglottis and exposing the vocal cords; also called the Macintosh blade.
Cyanosis
Blue or purple skin; indicates inadequate oxygen in the blood.
delayed sequence intubation (DSI)
A procedure in which a patient is sedated for the purpose of preoxygenation prior to the administration of a paralytic and intubation.
denitrogenation
The process of replacing nitrogen in the lungs with oxygen to maintain a normal oxygen saturation level during intubation
Depolarize got neuromuscular blocker
A drug that competitively binds with the acetylcholine receptor sites but is not affected as quickly by acetylcholinesterase; an example is succinylcholine chloride.
Digital intubation
A method of intubation that involves directly palpating the glottis structures and elevating the epiglottis with the middle finger while guiding the endotracheal tube into the trachea by using the sense of touch.
Direct laryngoscopy
Visualization of the airway with a laryngoscope
Dissociative anesthetic
A medication that distorts perception of sight and sound and induces a feeling of detachment from environment and self.
dysphonia
Difficulty speaking
Dyspnea
Difficulty or labored breathing.
Endotracheal (ET) tube
A tube that is inserted into the trachea for definitive airway maintenance; equipped with a distal cuff, proximal inflation port, a 15/22-mm adapter, and centimeter markings on the side.
Endotracheal (ET) intubation
Inserting an endotracheal tube through the glottis opening and sealing the tube with a cuff inflated against the tracheal wall.
End-tidal carbon dioxide (ETCO2) monitors
Devices that detect the presence of carbon dioxide in exhaled air.
epiglottis
A leaf-shaped cartilaginous structure that closes over the trachea during swallowing.
Esophageal detector device
A bulb or syringe that is attached to the proximal end of the endotracheal tube; a device used to confirm proper endotracheal tube placement.
Extubation
The process of removing the endotracheal tube from an incubated patient.
Face-to-face intubation
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.
Fasciculations
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).
gag reflex
An automatic reaction when something touches an area deep in the oral cavity that helps protect the lower airway from aspiration.
Gastric distention
The enlargement or expansion of the stomach, often with air; can be a complication of ventilating the esophagus instead of the trachea.
Gastric tube
A tube that is inserted into the stomach to remove its contents
Gum elastic bougie
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.
Head tilt chin lift maneuver
Manual airway maneuver that involves tilting the head back while lifting up on the chi; used to open the airway of an unresponsive nontrauma patient.
Hemoglobin
An iron-containing protein within red blood cells that has the ability to combine with oxygen.