Chapter 5, Airway and Ventilation Flashcards
What are some factors that adequate perfusion depends upon?
Airway patency
Ventilators effort
Gas exchange in the alveoli
Hemoglobin’s oxygen-carrying capacity
Cardiac output
What is SaO2?
The percentage of oxygen-saturated hemoglobin in arterial blood
> 95%
What is SpO2?
The percentage of saturated hemoglobins in the capillary bed.
> 94%
What is PaO2?
Amount of oxygen dissolved in plasma.
> 80 mmHg
What is PaCO2?
Partial pressure of carbon dioxide in arterial blood.
35-45 mmHg
What is ETCO2?
Maximum concentration of CO2 at the end of each breath.
35-45 mmHg
What is FiO2?
Fraction of oxygen in the air mixture that is delivered to the patient.
0.21 (room air) - 1% (100% oxygen)
What is hypoxemia?
PaO2 < 80 mmHg (normal = 80-100 mmHg)
What is hyperoxia?
PaO2 > 100 mmHg (normal = 80-100 mmHg)
What is assumed when patients have distracting injuries and altered mental status?
That they have sustained a spinal cord injury.
What are two ways to achieve spinal motion restriction (SMR)?
Manual stabilization
Semi-rigid cervical collar
How should the airway be opened in a patient that is unable to open their mouth, responds only to pain, or is unresponsive?
Jaw-thrust maneuver
How do you assess the placement of a definitive airway?
CO2 detector after 5-6 breaths
Observe rise and fall of the chest
Auscultate (over epigastrium and chest)
How should oxygen to the trauma patient be delivered initially?
10-15 LPM via nonrebreather mask
How should breaths be delivered using a bag-mask device?
1 breath every 6 seconds (10 breaths per minute)
Over 1 second
Attached to an oxygen source
What may occur if excessive volume is delivered via the bag-mask device?
Gastric distention
Vomiting
Aspiration
Barotrauma
Who is a candidate for a NPA?
Conscious
Semi-conscious
Intact gag reflex
When is a NPA contraindicated?
Facial trauma
Basilar skull fracture
(Risk for placing in cranial cavity)
How do you determine the length of an NPA?
Tip of the patient’s nose to the tip of their earlobe.
Who is a candidate for a OPA?
A patient without a gag reflex.
How do you measure an OPA?
From the corner of the mouth to the angle of the mandible.
What are examples of a supraglottic airway?
I-gel, LMA.
What is an example of a retroglottic airway?
King tube.
What are the indications for immediate definite airway management?
Failure of the patient to protect their airway.
Failure to maintain oxygenation or ventilation.
A specific, anticipated clinical course.
What isolation precautions must be taken when placing an ETT?
Contact & airborne precautions.
What are two methods to perform a cricothyroidotomy?
Needle catheter
Surgical insertion
What is a mnemonic to assess for airway difficulty?
L: Look externally (trauma, deformity, abnormal anatomy)
E: Evaluate (3,3,2)
M: Mallampati score (evaluates mouth opening to size of tongue)
O: Obstruction/obesity (hematoma, upper airway injury)
N: Neck mobility (cervical spine stabilization)
What is DAI?
Drug assisted intubation
What is RSI?
Rapid sequence intubation
Use of sedative followed by neuromuscular blocking agent
What is a prerequisite tor DAI?
High flow preoxygenation at max concentration for at least 3 minutes.
How does one secure and verify ETT placement?
Note the measurement at the teeth or gums and document.
Chest radiograph.
What is a sign of improved outcomes and mortality rates pertaining to lactate?
Stabilization within 24 hours.
What does a shift to the right indicate on the oxyhemoglobin dissociation curve?
An environment of high metabolic demand.
Hemoglobin’s affinity for oxygen decreases.
Decreased pH.
Increased Pco2.
Increased temp.
What does a shift to the left indicate on the oxyhemoglobin dissociation curve?
An environment of low metabolic demand.
Hemoglobin’s affinity for oxygen increases.
Increased pH.
Decreased Pco2.
Decreased temperature.
What is a mnemonic to troubleshoot ventilator, capnography, or pulse oximetry alarms?
D: Displacement
O: Obstruction
P: Pneumothorax/tension pneumothorax
E: Equipment (tubing leak, cuff pressure loss, disconnection)
What are the 7 Ps of RSI?
Preparation
Preoxygenation
Preintubation optimization
Paralysis with induction
Positioning with protection
Placement with proof
Postintubation management
