Chapter 9 Airway Management

Question 1

Patent

Answer 1

“Open and Clear Airway” &

“Will Remain Open and Clear”

Question 2

Suctioning Define and facts

Answer 2

method of using a vacuum like device to remove such materials
- to be effective must furnish an air intake of at least
30 liters per min at open end
- when clamped it will generate a vacuum of no less then 300mmHg
- Suction no longer then 10 seconds*

Question 3

Lower Airway

Answer 3

begins below Larynx and includes: Trachea, Bronchial Passages and alveoli

Question 4

Preferred method for airway insertion for infant/child

Answer 4

Insert airway with tip already pointing down toward pharynx, using a tongue depressor to push tongue down and forward
*hook um

Question 5

Head-tilt, chin-lift maneuver

Answer 5

A means of correcting blockage of the airway by the tongue by tilting the head back and lifting the chin.
- used when no trauma, or injury, is suspected

Question 6

Two Ways to Open an Airway

Answer 6

Head-tilt, Chin lift, Jaw Thrust is a move that considers

C-spine precaution

Question 7

Pediatric note on airway for Infants/Children

Answer 7

• Mouth/ nose smaller, easier to obstruct
• Tongue takes up more space in mouth then adults
• Trachea is softer more flexible / Narrower
• Chest wall is softer/ depend more on diaphragm for breathing
• Do Not HyperExtend neck when openings airway
• Be Gentle
• use rigid tip when suctioning

Question 8

Rigid pharyngeal tip
(Yankauer)
Facts and cautions

Answer 8

Allows suction with excellent control

• larger bore
• must watch out for gag reflex when placed in pharynx
  - also possible to stimulate “Vagus Nerve” in back of pharynx which can slow HR

Question 9

Look, Listen, Feel

Answer 9

Method of assessment used to ensure that the airway is open and to assess future or occurring problems.

Used If a person is unconscious or alert

Question 10

gag reflex

Answer 10

vomiting or retching that results when something is placed in the back of the pharynx. this is tied to the swallow reflex

Question 11

Carina

Answer 11

Fork at the end of trachea leading into the bronchi

Question 12

Special considerations in Airway Management

Answer 12

Facial injuries - may result in swelling or bleeding that may partially block airway
Obstructions - suction not adequate to take out solid objects: Abdominal Thrust, chest thrusts and finger sweeps are some manual techniques to clear airway manually
Dental Appliances - dentures should be left
but be prepared to remove it if it endangers airway

Question 13

Adjuncts

Answer 13

Devices that aid in maintaining an open airway

Ex: OPA, NPA

Question 14

Suction Catheters

Answer 14

More Flexible

• usually not large enough to suck Vommit or thick secretion
• sizes identified by “French” higher the number bigger the tube

Question 15

Septum

Answer 15

Base of the nostril - wall that separates the nostrils

Question 16

Oropharyngeal

OPA

Answer 16

A curved device inserted through the patients mouth into the pharynx to help maintain an open airway.

• Oral Airway
• Gently rotate 180 degrees so tip is facing downward.
• have suction ready prior to inserting any airway
  
  • size by corner of mouth to earlobe

Question 17

Bronchoconstriction

bronchospasm

Answer 17

Contraction of Smooth muscles that lines the bronchial passages that result in a Decreased Internal Diameter of the airway and Increased Resistance to Airflow.
Ex: Asthma or CPD

Question 18

Difficulty Moving Air

Answer 18

Gasping, crowing,wheezing, snoring, and stridor

Question 19

Retractions

Answer 19

Pulling of the muscles around clavicles and between/below ribs

Question 20

Suctioning Techniques

Answer 20

1. use appropriate PPE’s
2. limit suctioning to less then 10 seconds
3. put suctioning device where you want to begin and suction on the way out

Question 21

Jaw-thrust maneuver

Answer 21

Maneuver to open airway by moving the jaw forward without tilting the head or neck.

• used when trauma or injury is suspected to the spinal cord or neck
• only recommended airway procedure for unconscious spinal injury is suspected

Question 22

Best position to carry out artificial ventilation

Answer 22

Supine position, Always take C-spine Precautions

Question 23

Sniffing Position

Answer 23

Bolt upright position, with head pitched forward as if they were trying to sniff something.
- in a person with a partially obstructed airway

Question 24

Laryngopharynx

Hypopharynx

Answer 24

Structure surrounding the entrance to the trachea

- designed to provide structure to and protect the entrance to the trachea

Question 25

Stridor

Answer 25

A high pitched sound generated from partially obstructed airflow in the upper airway.

Question 26

Nasopharyngeal

NPA

Answer 26

A flexible breathing tube inserted through the patients nostrils into the pharynx to help maintain an open airway

• bevel should point toward base of nostril (septum)
• used when teeth or jaw is clenched or oral injuries
• lubricate outside of the tube w/ water based lube
• have suction ready prior to inserting any airway

*Note DO NOT use NPA if clear cerebrospinal fluid is coming out of nose or ears

Question 27

What has priority: Airway or spinal injury?

Answer 27

Airway always has priority

Question 28

Crossed finger technique

Answer 28

Method to open mouth

Cross the thumb and forefinger of one hand and place them on the upper and lower teeth at corner of mouth

Question 29

NPA designed to go in which nostril

Answer 29

Right nostril is used for insertion

Question 30

Suction unit consists of

Answer 30

• suction source
• collection container
• tubing
• and suction tips or catheters

Question 31

Stridor indicates

Answer 31

• Upper airway obstruction
• Usually partially obstructed but very close to fully obstructed
• High pitched sound
• caused by foreign body, swelling of upper airway tissues or infection

Question 32

Hoarseness indicates

Answer 32

• Voice changes Reflects upper airway narrowing
• happens when there swelling in airway from burn or allergic reaction
• development is often an ominous sign

Question 33

Snoring indicates

Answer 33

• Sound of soft tissue of upper airway creating a partial obstruction
• common when sleeping
• in the case of injury may indicate AMS (altered mental status) by airway muscle tone being diminished

Question 34

Gurgling indicates

Answer 34

Sound of fluid obstructing airway

- immediate sign to suction patient