Chapter 6a - Airway management Flashcards
conscious choking adult/child - alternate between 2 of 3 appropriate techniques:
- bent over backblows x 5
- abdominal thrusts x 5
- chest thrusts
Procedure for unconscious choking child - alone
do 2 min CPR
call EMS/911
Open mouth + visualize + remove object if seen
Open airway + attempt 2 breaths
30 chest compressions
visualize mouth + remove object
REPEAT until EMS arrive or successful retrieval
If coughing gagging, do you interfere
NO
if high pitched, wheezing, no sound, do you interfere
Send someone to call EMS/911
procedure for conscious choking infant
kneel down to floor and place baby on your thigh
give 5 back blows
give 5 chest thrusts
continue until unconscious
procedure unconscious choking infant
ensure EMS/911 has been called
check mouth
attempt ventilation/reposition/attempt again
baby CPR. check mouth before breaths
sweep only if visualized
once unobstructed, CPR only as needed
Allergic reaction in which the immune system reacts in a sudden and exaggerated way to contact with an allergic substance (antigen)
Anaphylaxis
in order to be severely allergic to something, you must be in contact with it ____
at least once
what creates the damage to tissues during anaphylaxis? what do they cause?
histamine and leukotrienes
they cause swelling, hives, eventual breathing problems when tissue around airway is involved
Management of anaphylaxis
Call 911
Epinephrine - autoinjector
O2
Oral antihistamines may help reduce sx
Administer epinephrine ONLY when patient is breathing
TRUE
Considered anaphylaxis when ____ systems are involved
2 or more
When can you give a second dose of epi in anaphylaxis reaction?
after 5 minutes, usually repeated every 15 min - no max
Can you use an expired epipen?
yes if that is all that is available
2 populations with whom we need to be careful when delivering epi
older victims
cardiac victims
inclusion criteria for administration of epi
known to be allergic
not known to be allergic
exclusion criteria for administration of epi
no exclusion criteria for anaphylaxis (medical emergency)
Can you administer an epipen to someone who is not known to be allergic therefore has no epipen?
yes
what are the first signs of an allergic reaction? (5)
difficulty breathing
weakness
fainting
itchiness
urticaria
for someone who is not known to be allergic, what are the first signs?
recent contact with causal agent less than 12h ago
AND
respiratory distress or circulatory failure or visible edema of the tongue
general management guidelines for anaphylaxis (6 steps)
- evaluate safety
- ABC , call 911, admin O2
- inclusion criteria ? known or unknown?
- if allergic give epinephrine based on weight
- monitor & provide first aid, repeat epi every 15 min
- always take to hospital (biphasic!)
Effects of epinephrine (5)
dilates bronchioles
increases BP
increases Pulse (may cause palpitations)
anxiety/trembling/nausea/vomit
effects are of short duration
3 things to verify on epipen before using it
6 rights of medications
medication is clear not cloudy
expiration date
tip to remember how to use epipen
blue to the sky orange to the thigh
accidental injection with used needle - 2 steps
squeeze injection site to force bleed
clean with soap + water or disinfectant
accidental injection - sterile needle - 3 steps
hot compresses
downward position
immediately go to hospital ER
best initial airway technique for non spinal injured athlete
head-tilt chin-lift
name the 5 breathing devices
OPA
NPA
PM
NRB
BVM
4 advantages of breathing devices
maintains an open airway
to perform rescue breathing
limits the potential for disease transmission
increase the blood O2 concentration
what is an OPA
oro-pharyngeal airway
depth measurement of OPA
from ear lobe to corner of mouth
breathing device used only on unconscious patients who do not have a gag reflex
OPA
3 insertion techniques for OPA
90 degree
180 degree
tongue depressor
what is an NPA
Nasopharyngeal airway
breathing device used on semi-conscious or with trismus (jaw spasm)
NPA
depth measurement of NPA
earlobe to tip of the nose (or middle top lip or proximal nares)
NPA - left or right nares ? towards or away from the septum?
right nares towards the septum
When is it okay to use the igel?
only after the 6th minute with a cardiac arrest (no breathing no pulse) if other methods have not worked
Where is the upper lung sound placement?
under clavicle
where is the lower lung sound placement?
axillary line under the nipple
can we insert supra-glottic airway device if victim is side-lying?
YES - to secure airway
procedure to use suctioning device
protect airway (turn to side if no spinal/roll if spinal)
open mouth remove OPA, NPA and mouth guard
remove large debris
max time for adult suctioning
15 sec
max time for child suctioning
10 sec
max time for baby suctioning
no more than 5 sec
Suction on the way in or out
OUT
in the mouth - Suction farther than what you can visualize
false , only as far as you can visualize
for the nose, use a small or large catheter? how do you measure
small bore catheter
measure same as for an NPA
in the nose - suction farther than what you can visualize
blind suctioning, do not go too far
two types of catheter for suction
rigid
soft
urgent suction intervention steps
if supine and actively vomiting
-turn head to the side + pull out OPA
- visualize and use rigid catheter
- if spinal suspected, first log roll, keep on side
- suction as long as they are vomiting
non-urgent suction interventions steps
if presence of some fluid in NPA, nose, mouth, beside OPA
- suction whenever any sounds/gurgling is heard before it is an issue
- suction 15 sec adult, 10 sec child, 5 sec baby
- advanced airway should be suctioned soon after insertion as a precaution
do you remove the OPA before or after the emergency log roll?
after the roll
