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TNCC > Chapter 4 - Airway and Ventilation > Flashcards

Chapter 4 - Airway and Ventilation Flashcards

1
Q

Upper airway parts

A
  • nose, mouth, pharynx, larynx, epiglottis and trachea

These help to humidity filter and transport inhaled air from the atmosphere to the alveoli

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2
Q

Lower airway

A

bronchi, lungs and alveoli

These help for circulatory gas exchange

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3
Q

Diffusion

A

gases move from higher to lower concentration
- oxygen enters the alveoli and Carbon dioxide escapes

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4
Q

Perfusion

A

the movement of blood through the circulatory system through the heart and lungs

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5
Q

What can cause airway obstruction in the trauma patient

A

Altered LOC
Secretions
Maxillofacial trauma
Neck or larynx trauma

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6
Q

Oxygen - Sa02 meaning

A

Percentage of red blood cells with hemoglobin bound to oxygen

ABG > 94%

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7
Q

Oxygen Sp02 meaning

A

perf. oxygen sat. >94%

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8
Q

Oxygen Pa02 - meaning

A

amount of oxygen dissolved in plasma

Normal ABG - 80-100 mmHG

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9
Q

Ventilation - Pac02

A

the partial pressure of carbon dioxide in the blood (c02) in arterial blood 35-45 mmHg

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10
Q

ETC02 - meaning

A

max concentration of C02 at the end of each breath.

Normal > Capno 35-55 mmhg
colorimetric 2-5 % ETCO2 (15-38 mmHG)

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11
Q

Hypoxemia

A

insufficient level of oxygen in the blood - pa02

Normal 80-100 mmHg

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12
Q

Hypoxia

A

Inadequate oxygen supply to the tissue - pa02

Normal 80-100 mmHG

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13
Q

Hyperoxia

A

excess of supplemental oxygen in the blood

Normal Pa02100 mmHg
Hyperoxia Pa02 > 120 mmHg

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14
Q

Breathing - rates

A

10-12 per min
= one every 5-6 seconds

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15
Q

NPO

A

tip of nose to tip of ear lobe - common R) nare

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16
Q

circ. complications

A
  • hemorrhage
  • pneumomediastinum
  • lac to cricoid ring
  • tracheal trauma
    -subglottic stenosis
  • vocal cord damage
17
Q

LEMON - difficult airways

A

(L) - look; assess for patient trauma to fae.
(E) evaluate - 3-3-2 (3 fingers in mouth, 3 between chin and neck and 2 between neck and mandable)
(M) mallampti score ; mouth opening to size of tongue
(O) obstruction / obseity
(N) neck mobility

18
Q

How do you know if an ETT is in?

A

a. rise and fakk of chest
b. listen to any presence of gurgling over the epigastusm, which may indicate the tube in the esophagus.
c. bilateral breathe sounds
d. CO2 (POSITIVE IF WE SEE C02 EXHALED after 6 breathe)

*Breath sounds are heard only on the R) side indicates that the ETT could be in the right stream bronchus and has been inserted too far

19
Q

LABS - BASE AND LAC

A

Base deficit serves as an endpoint measurement of the adequacy of cellular perfusion.

A lactate that normalises with 24 hours of injury due to regulation and supportive care is connected to improved outcomes

20
Q

Intubation technique - BURP

A

Backward
Upward
RIght ward
pressure

21
Q

Seven P’s of rapid sequence intubation

A

Preparation
Pre-oxygenate
Pre intubation optimization
Paralysis with induction
Protection (airway from aspiration)
Placement with proof
Post intubation management

22
Q

Intubation - pre-treatment drugs (2)

A

Lignocaine
- may reduce the risk of ICP during intubation
ONSET = 45-90 seconds
Duration = 20 minutes

Fent.
- mitigates sympathetic response (increased BP and HR)
ONSET 2-3 minutes
Duration = 30-60 minutes

23
Q

Induction drugs (4)

A

Etomidate
- acts of gaba receptors to block neuroexciration and produce anesthesia.
ONSET - 15-45 seconds
Duration 3-12 minutes

Ketamine
- acts on GABA receptors, causing neuro inhibition and anesthesia, antagonises opioid receptors causing analgesia
ONSET - 45-60 seconds
Duration 10-20 minutes

Midaz
- acts on gaba receptor complex to produce sedation and amenia
ONSET - 30-60 seconds
DURATION- 15-30 minutes

Prop
- sedative amnestic agent, suppresses brain activity and inhibits long term memory creation
ONSET - 15-45 second
Duration 5-10 minutes

24
Q

Paralysis drugs (3)

A

Sux
- depositing agent that stimulates all chlorogenic receptors (synthetic and parasynmathic casing paralysis)
ONSET - 45-60 seconds
DURATION 6-10 minutes

ROC
- a nondepolarising agent that inhibits neuromuscular receptors, causing muscular paralysis
ONSET - 45-60 seconds
DURATION - 45 minutes

Verc.
- nondepolarizing agent that inhibits neuromylar receptors causing muscle paralysis
ONSET - 75-90 seconds
DURATION - 25-40 minutes

25
Q

Heart electrical activity flow

A
  • SA
  • AV
  • Bundle of his
  • R + L bundle branches
  • Purkinjie fibres
26
Q

4 valves

A

To the heart
- mitral
- tri-cuspid

OUT of the heart
- aortic
- pulmonic

27
Q

Heart blood flow (IN)

A

Goes “right to the lungs”

  1. SVC/IVC
  2. Right Atrium (RA)
  3. Tricuspid Valve (TV)
  4. Right Ventricle (RV)
  5. Pulmonary Valve (PV)
  6. Pulmonary artery (PA)

LUNGS

28
Q

Heart blood flow (OUT)

A

Goes left back into the heat

  1. Pulmonary veins (PV)
  2. Left atrium (LA)
  3. Mitral Valve (MV)
  4. Left ventricle (LV)
  5. Aortic valve (AV)
  6. Aorta

TNCC (18 decks)

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