devices Flashcards

1
Q

Two types of airway devices

A

tracheal and pharyngeal

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2
Q

examples of tracheal airway devices

A

endotracheal tube and tracheostomy tube

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3
Q

Examples of pharyngeal airway devices

A

nasopharyngeal airway
oropharyngeal airway
laryngeal mask airway
combitude airway

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4
Q

two most common type of artificial airway are

A

endotracheal tube and tracheostomy tube

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5
Q

Indication of tracheal intubation

A

to bypass an upper airway obstruction
to protect the airway from aspiration
to apply positive pressure breathing
to aid clearance of secretion
to deliver high oxygen concentrations

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6
Q

It is a flexible plastic tube that is inserted to the patients mouth into the trachea to help sustain spontaneous breathing

A

Endotracheal tube

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7
Q

The process of inserting et tube into the airway of the patient is called

A

endotracheal intubation

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8
Q

The et tube can be determine by the

A

inner diameter or ID

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9
Q

Requires injection of pressurized air into the balloon to create a seal onto the inside walls of the airways.

A

Cuffed et tube

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10
Q

It is recommended for children less than 8 years old to prevent narrowing of the trachea

A

uncuffed et tube

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11
Q

This indicate the placement of the et tube

A

Centimeter marking of et tube

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12
Q

The average distance from the tip to the carina in male is______ female is______

A

27 cm, 25 cm

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13
Q

Tape the tube at what cm in males and females (taping mark)

A

males- 22-25 cm, female-20-23 cm

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14
Q

The tip of the et tube must rest _____above the carina

A

2-5cm

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15
Q

In auscultation to confirm position of the et tube you should hear what sounds

A

bilateral breath sounds of right and left lung

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16
Q

Protects the patient from aspiration and help to give the patient positive pressure ventilation

A

Cuff

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17
Q

Use to inflate and deflate et tube cuff and connected to _____

A

pilot balloon, manometer

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17
Q

Use to inflate and deflate et tube cuff and connected to _____

A

pilot balloon, manometer

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18
Q

What is the normal cuff pressure

A

25-35 cm H2O

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19
Q

Indication of endotracheal intubation

A

To relieve upper airway obstruction
To protect the airway
Facilitation of tracheal suctioning
Assistance in manual ventilation//mechanical ventilation

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20
Q

What are 4 airway protective reflex

A

pharyngeal reflex
laryngeal reflex
tracheal reflex
carinal reflex

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21
Q

What reflex that is responsible in preventing choking

A

Gag reflexes

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22
Q

Other term for carinal and tracheal reflex

A

cough reflex

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23
Q

How reflexes are obtunded

A

paralysis
anesthetized patient
unconscious patient
neuromuscular disease

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24
Q

What are the hazards in endotracheal intubation

A

Loss of patient ability to talk
Loss patient ability to eat using mouth
Tube occlusion with inspissated secretion
Damage vocal cord

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25
Q

How intubated patient ingest foods that turns solid food to liquid

A

NGT nasogastric tube

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26
Q

What are the complication of et intubation

A
  1. Poorly tolerated by the conscious and semi-conscious patient
  2. Gagging caused by the tube irritation
  3. Harder for the patient to communicate
  4. Patient may bite the tube which may cause occluding airflow and a mechanical ventilator airflow alarm is triggered.
  5. Erodes, corner of patient’s mouth
  6. Stimulates oral secretions
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27
Q

Used to shape the et tube to be easier to be inserted. Gives rigidity and prevents et tube to bend.

A

stylet

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28
Q

It is a surgical opening in the neck and trachea that provides access for the insertion of an artificial airway known as_______

A

tracheostomy, tracheostomy tube

29
Q

Hole in the trachea without the tube in place

A

Stoma

30
Q

How many cm of incision of the neck for stoma

A

3-4 cm

31
Q

Tracheostomy tube are placed on what tracheal ring

A

Between second and third tracheal ring

32
Q

How many percent of tracheal diameter to occupy the tracheostomy placement

A

65-75%

33
Q

Inserted directly to the trachea via stoma

A

tracheostomy tube

34
Q

Indication of tracheostomy intubation

A
  1. the patient will require mechanical ventilation for more than one or two weeks.
  2. the patient can’t manage their own secretions and require frequent tracheal suctioning
  3. The patient has a difficult airway or sudden trauma/swelling in their upper airway and attempts to intubate via the endotracheal have failed
35
Q

Risk and complication of tracheostomy

A
  1. Obstruction to the tracheostomy tube from secretions or blood clot that prevents ventilation
  2. Infection
  3. Accidental decannulation of the tracheostomy tube
36
Q

How does tracheostomy tube work

A

By allowing the patient to breathe via tracheostomy that has been inserted into their stoma, bypassing their upper airway completely

37
Q

These are developed for patient that require positive ventilator and airway protection

A

Cuffed tracheostomy tube

38
Q

These are used when patient no longer needs to positive pressure ventilation and has no significant aspiration risk

A

Uncuffed tracheostomy tube

39
Q

Tracheostomy tube sizes
1. preemie under 2 kg:
2. Infant:
3. 6-18 months old:
4. 18 months old to 5 year old:
5. 4year old- 10 year old:
6. 10 year old- 14 year old:
7. 14 year old and up:

A
  1. 2.5 mm ID
  2. 3.0-3.5 mm ID cuffless neonatal size
  3. 3.5-4.0 mm ID neonatal or pediatric size
  4. 4.0-4.5 mm ID pediatric size
  5. 4.5-6.0 mm ID pediatric size
  6. 5.0-6.5 mm ID pediatric size
  7. 6.0-9.0 mm ID adult size
40
Q

It can restore airway patency and maintain adequate ventilation , in particular, when using bag-mask device.

A

Pharyngeal airways

40
Q

It can restore airway patency and maintain adequate ventilation , in particular, when using bag-mask device.

A

Pharyngeal airways

41
Q

Nasopharyngeal airway a.k.a

A

Nasal horn/ nasal trumpet

42
Q

It is inserted through one of the nares and past the turbinates

A

Nasopharyngeal airway

43
Q

Nasopharyngeal airway advantage:
It can be used in ________ victims with potential problems with the self-control of the airway. It can be used in situations where the victims have_______. It can also be used in victims with _______. It does not require ______ during insertion. Patient with _____

A

semi-conscious, extensive injury to mouth/lower jaw, intact gag reflexes, hyperextension of the neck, seizure

44
Q

The disadvantage of nasopharyngeal airway
should not be used if:

A

Severe nasal bleeding
If: suspected basilar skull fractures, trauma to the nose if present, resistance is met when attempting to advance the device.

45
Q

What are the advantages of oropharyngeal airway

A

Prevent airway obstruction by the tongue
To be used as a bite block
To increase the effectiveness of bag/mask ventilation

46
Q

Contraindication of oropharyngeal airway

A

A conscious patient with gag reflex

47
Q

What are the two techniques to insert oropharyngeal airways

A
  1. The tongue is displaced away from the roof of the mouth with a tongue depressor. The curved portion of the airway is slipped over the tongue, following the curve of the oral cavity. the oropharyngeal airway is rotated 180 degrees before insertion.
  2. jaw-lift technique displaces the tongue
48
Q

Laryngeal mask airway

A

a small, triangular-shaped inflatable mask that is secured to a tube, similar in size to an ETT

49
Q

Advantages of LMA

A

a. this airway can be quickly inserted to provide ventilation when bag-mask ventilation is not adequate and ET intubation cannot be accomplished
b. LMA ventilates equally as well as an et tube
c. training is simpler than for an et intubation
d. there is no risk of esophageal or bronchial intubation
e. there is less risk of trauma to the airway than with ET intubation.

50
Q

Contraindication for LMA

A

Patient is conscious or resist placement of LMA
Patient is known to have or might have food in the stomach
Patient has GERD

51
Q

A double-lumen airway that is inserted blindly into the oropharynx and advanced into the esophagus or trachea. It has feature similar to ETT

A

Combitude

52
Q

The combitude has been used effectively in____

A

cardiopulmonary resuscitation

53
Q

It has been used successfully in patients with ____________________where there was an ability to visualize the vocal cord.

A

difficult airways secondary to severe facial burns, trauma, upper airway bleeding, and vomiting

54
Q

The combitude can only be used in the adult population as no pediatric sizes are available. T/F

A

T

55
Q

Tracheostomy tube is made usually of _______

A

silicon and polyvinyl material

56
Q

how much pressure use in cuff tracheostomy tube

A

20-30 cm h2O

57
Q

If pressure in the cuff is too high it can_____

A

cut off mucosal blood flow, tracheal stenosis

58
Q

If pressure in the cuff is too high it can_____

A

cut off mucosal blood flow, tracheal stenosis

59
Q

if the pressure is the cuff is too low it can_____

A

affect the delivery of positive pressure ventilation, airway is not protected from aspiration

60
Q

It is a special type of tracheostomy tube that has an opening above the cuff which allows the airflow to pass so that the patient is able to talk when an airway is place

A

Fenestrated tracheostomy tube

61
Q

Hole or opening in the shaft of the tube

A

fenestration

62
Q

The outside diameter of the airway should be equal to the inside diameter of your _______.

A

patient-external nares

63
Q

How to determine the size of nasopharyngeal airways by____

A

measuring the tip of your earlobes into your center of the nostrils

64
Q

indication of oropharyngeal airway

A

conscious and non-responsive patient
difficulty in maintaining patent upper airway

65
Q

how to determine the size of oropharyngeal airway

A

Measuring from the angle of the jaw to the tip of the chin

66
Q

What are the two common oropharyngeal airway design

A

Guedel airway and Berman airway

67
Q

Has two horizontal plates connected by one ridge in the center of the airway. Each side of this ridge serves as the channel to pass a _________ to the laryngopharynx. The horizontal plates provide a flat surface for the teeth to contact. the smooth rounded tip to prevent the _______

A

Berman airway, suction catheter, trauma to the soft tissue of the upper airway

68
Q

Design with one smooth channel through the center

A

Guedel airway

69
Q

What is the purpose of laryngeal mask airway

A

to prevent gastric aspiration while providing a patent airway

70
Q

To determine with should to ventilate through attach your combitude into a ______ To determine where the combitude lies, use_______

A

resuscitator bag/ bvm, carbon dioxide detector