Chapter 2 - Airway And Ventilatory Management Flashcards
What must be given to all trauma patients?
Supplemental oxygen
Regarding airway management, what is the quickest killer?
Inadequate delivery of oxygenated blood to the brain and other vital structures.
Describe the importance of “the talking patient?” (p. 32)
The talking patient gives a positive, appropriate verbal response which indicates that their airway is patent, ventilation is intact and brain perfusion is adequate.
If someone has an altered level of consciousness what do they require? (p. 32)
A definitive airway
What is the definition of a definitive airway? (p.32)
A tube placed in the trachea with the cuff inflated below the vocal cords, the tube connected to some form of oxygen-enriched assisted ventilation, and the airway secured in place with tape.
What sort of patients may require a definitive airway due to compromised ventilatory effort? (p. 32)
1/ Unconscious patients with head injuries 2/ Obtunded from alcohol & Drugs 3/ Thoracic injuries
What is the purpose of endotracheal intubation? (p.32)
1/ Provide an airway 2/ Deliver supplementary oxygen 3/ Support ventilation 4/ Prevent aspiration
Maintaining (blank) and preventing (blank) are critical in managing trauma patients, especially those who have sustained head injuries. (p.32)
1/ oxygenation 2/ preventing hypercarbia
If a patient is unconscious and vomits or has gastric contents in his/her airway, what should you do? (p.32)
1/ Immediate suctioning 2/ Rotation of the entire patient to the lateral position.
What 3 things can facial fractures be associated with? (p.32)
1/ Haemorrhage 2/ increased secretions 3/ Dislodged teeth
What can fractures of the mandible cause (especially bilateral body fractures?) (p.32)
Loss of normal airway structural support.
A fractured larynx manifests itself with a triad of clinical signs. What are they? (p.33)
1/ Hoarseness 2/ Subcutaneous emphysema 3/ Palpable fracture
If noisy breathing suggests partial airway obstruction, what does absence of breathing suggest? (p.33)
It suggests complete airway obstruction
What investigation would be useful if a fractured larynx is suspected? (p.33)
A CT
What are the 4 objective ways of finding signs of airway obstruction? (p. 33)
1/ OBSERVE- the patient may be agitated, fingers may be cyanotic, circumoral skin and nail beds may be poorly perfumed. The person may be using accessory muscles when breathing. 2/ LISTEN- The patient may have noisy breathing, stridor which would indicate partial occlusion of the larynx or pharynx. Hoarseness implies laryngeal obstruction. 3/ FEEL - for the location of the trachea to see if midline or deviated. 4/ EVALUATE - Abusive or belligerent patients may be intoxicated.
What is this airway device called and how does it work?
A Multilumen esophageal airway. One of the ports communicates with the oesophagus whislt the other communicates with the trachea. The oesophagus port is then occluded with a balloon and the other ventilated.
What type of airway device is this?
This is a Laryngeal Mask Airway (LMA). It is a type of Extraglottic/Supraglottic airway device.
What airway device is this and how does this work?
This is a laryngeal tube airway. (LTA). It is placed without viewing the glottis and does not require significant manipulation of the head and neck. (Just like an LMA)
Describe the 4 step process of removing a helmet in a trauma patient?
1/ One person provides manual, inline stabilization of the head and neck.
2/ The other person expands the helmet laterally and removes it.
3/The first person then supports the weight of the patient’s head.
4/ The second person then takes over inline stabilization.
Mallampati Classifications
Describe the 3-3-2 Rule.
3= the distance between the incisor teeth.
3= the distance between the hyoid bone and the chin
2= distance between the thyroid notch and the floor of the mouth
Name and describe this maneouvre.
This is the chin lift maneuver. The fingers of one hand are placed under the mandible which is lifted gently upward.
It should NOT hyperextend the neck.
What maneuvre is this and describe it?
This is the Jaw-Thrust Maneuver. The angles of the lower jaw are grasped and the mandible is displaced forward.
Do NOT hyperextend the spine.
Name this airway and how do you insert it?
Oropharyngeal airway.
It is inserted into the mouth until it reaches the soft palate. It is then rotated 180 degrees and the device is slipped into place over the tongue.
NOTE: This method should NOT be used in children as it can damage the soft palate. In children, suppress the tongue and then insert it .
Describe the indications for a definitive airway.
