Essential Airway Management Flashcards

1
Q

What does DRCACBC stand for?

A
Danger 
Response
Catastrophic haemorrhage
Airway
C-spine
Breathing
Circulation
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2
Q

What would you use the larger suction tube for?

A

Vomit

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3
Q

What would you use the smaller suctions tube for?

A

Fluids like saliva, and may also be used on children

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4
Q

How far should a suctioning tube be descended?

A

As far as you can see

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5
Q

How do you use a hand held suctioning pump? (6)

A

Connect bottle to hand controlled suction

Pick one of two tubes

Place tube as far as you can see

To build up pressure, pump the handle

Use zigzag motion as you move out of the mouth

Start pumping from further down and slowly move upwards

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6
Q

How do you suction using a battery powered suction? (5)

A

Ensure charge or power source

Attach tube

Use tougher catheter for adults and finer catheter for children

Insert catheter as far as you can see

Suction using zigzag motion upwards

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7
Q

How do you do a jaw thrust? (2)

A

Place fingers on corners of the jaw and place thumbs on cheekbones

Must be held for short period of time due to tiredness, and use of assisted ventilation should be used

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8
Q

When would you use airway adjuncts? (2)

A

When the head-tilt chin-lift or jaw thrust fails

Because they may cause tongue to fall back displacing the epiglottis causing airway obstruction

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9
Q

What are the three airway adjuncts?

A

Nasopharyngeal Airway (NPA)

Oropharyngeal Airway (OPA)

Bag-Valve-Mask (BVM)

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10
Q

When would you us an OPA?

A

When patient is unconscious

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11
Q

When would you use an NPA? (3)

A

When OPA stimulates gag reflex and is ineffective

Patient would be unconscious or partially unconscious

If trismus occurs - spasm of the jaw rendering the mouth shut

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12
Q

What can an NPA and an OPA also be used in conjunction with?

A

BVM

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13
Q

How would you use an OPA? (7)

A

Check consciousness

Check airway

Mouth piece sized from corner of jaw to surface of the mouth

Insert upside down (in children inserted right way up)

Once in contact with roof of mouth, rotate 180 degrees

If gagging remove mouthpiece

Attempt again. If can not withstand OPA, use NPA

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14
Q

How would you use an NPA? (8)

A

Can be used on semiconscious patients and gag reflex patients

Can be used on patients with facial injuries

Ensure no skull fracture or internal nose damage

Tube measured from patients nostril to tragus on the ear

Add lubricant to tube

Insert bevel end on wall of trachea

Push and twist horizontally down

If resistance, pull out and insert in other nostril

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15
Q

How do you use BVM? (8)

A

Fill bag with oxygen using tube connected to oxygen cylinder

Form tight seal around mouth using mask

Ensure correct size mask

Ensure patent airway

2 person technique

3 fingers around jaw and two on mask

Squeeze bag every 5 seconds

Sats should show decrease in CO2 and increase in O2

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16
Q

How do you prepare an oxygen cylinder before use? (5!

A

Check cylinder contents gauge on to ensure efficient gas content

Remove tamper evident seal and cover fitted over valve outlets

Ensure batch label fitted to cylinder and not removed

Appropriate size tubing to fir tree outlet

Open cylinder valve slowly and check for leaks

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17
Q

What is the target sats for most patients?

A

94-98%

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18
Q

What is the target sats for those at risk of type 2 respiratory failure like COPD? (High CO2 levels and low O2 levels)

A

88-93%

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19
Q

When is a nasal cannulae used? (3)

A

Used for type 1 and type 2 respiratory failure

Used on stable patients

Deliver low concentrations of oxygen

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20
Q

What is the flow rate of nasal cannulae?

A

2-6l/min

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21
Q

What is the flow rate for simple face mask?

A

5-10l/min

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22
Q

What oxygen percentage is delivered by nasal cannulae?

A

24-40%

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23
Q

When would a Venturi mask be used?

A

Used when specific O2 requirements are needed to be administered, e.g. oxygen for COPD

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24
Q

What is the target saturation rate for Venturi mask?

A

88-92%

25
Q

What is the percentage oxygen delivery range for Venturi mask?

A

24-60% depending on adapter

26
Q

What is the reservoir bag also known as?

A

Non-rebreather mask

27
Q

When is a reservoir bag mask used?

A

When there is high oxygen requirements

28
Q

What is the percentage concentration of oxygen delivered using reservoir bag mask?

A

60-80%

29
Q

What is the flow rate of the Venturi mask?

A

Specific to adapter

30
Q

What is the flow are of reservoir bag mask?

A

12-15l/min

Always start at 15

31
Q

When paramedics ask for mask giving 100% oxygen, which mask should be used?

A

Reservoir bag mask

32
Q

What mask is needed when paramedic asks for oxygen mask delivering normal levels of oxygen?

A

Simple face mask

33
Q

What drugs are used in nebulisers?

A

Salbutamol and ipratropium bromide

34
Q

What is the flow rate of a nebuliser?

A

6-8l/min

35
Q

How to use BVM solo? (6)

A

Check whether paediatric or adult mask

Connect tube on bag to oxygen cylinder

Then O2 to 15l/min

C shape seal

Ensure head-tilt chin-lift maintained

1 ventilation every 6 seconds = respiratory arrest

2 ventilations every 30 chest compressions = cardiac arrest

36
Q

When is a paraPAC used?

A

For machine controlled ventilation using either OPA or NPA

37
Q

What should the relief pressure button be placed on on the paraPAC?

A

30cmH2O

38
Q

What should the frequency button on the paraPAC be positioned on?

A

12

39
Q

What should the tidal volume button on paraPAC be positioned on?

A

800VTDEL

40
Q

What should the air mix button on paraPAC be positioned on?

A

Keep on no air mix meaning undiluted oxygen (not pure O2)

41
Q

When in use what should the demand//CMV/demand switch be on?

A

Use CMV when in use

42
Q

What does the red light on the paraPAC mean?

A

High pressure

43
Q

What does the green light mean on the paraPAC?

A

Monitor inflation pressure indicates high pressure

44
Q

What does the yellow button mean?

A

Low pressure indicating that the ventilators is not cycling correctly

45
Q

What does the orange light mean?

A

Silent alarm which lights every 3 seconds

46
Q

What does the green light mean?

A

It is a breathing indicator indicating low breathing rate

47
Q

What does the next yellow light indicate?

A

Indicates low battery every 2 seconds

48
Q

What should you do when using paraPAC? (6)

A

Connect ventilator to oxygen cylinder

Check to see gas supply failure alarm turn on white

Switch on (CMV/demand)

Single burst of audible alarm heard

Alarm lights should flash in sequence (one after the other)

Orange silencing indicator should flash every 60 seconds

During each inflation ensure green cycle indicator lights

49
Q

What is indicated when there is high pressure during inflation on the paraPAC?

A

Could indicate obstruction

Tidal volume is too high

50
Q

What is indicated by low pressure by the paraPAC? (4)

A

Check for leaks

Check tidal volume

Check pressure valve

Use 100% oxygen (for resuscitation - Air mix) or 50% with the use of oxygen supply (when stabilised use no air mix)

51
Q

What does SLAM part of Dynamic Risk Assessment stand for?

A

Stop

Look

Assess

Manage

52
Q

What does mean in SLAM?

A

Think “Am I safe? Is my crew-mate safe?”

53
Q

What does look mean in SLAM?

A

Actively look for hazards and risks

54
Q

What does assess mean in SLAM?

A

Level of risk “is it safe to approach or not?”

55
Q

What does manage mean in SLAM?

A

Manage risk by eliminating it, reducing it or managing it

56
Q

How should you respond to a cardiac arrest?

A

Check for danger

Try and get a response

Shake shoulders and ask loudly “can you hear me?”

No response = open airways

Lie flat on back with head straight up

Head tilt, chin lift

Look, listen and feel for breathing for 10 seconds

Abnormal breathing = 999 and AED

Start CPR

Chest compressions using heal of hand in centre of chest

2 times a second = 5-6cm
100-120bpm

2 ventilations after every 30 chest compressions

Use defib

Scissors used to cut clothing

Place pads

Turn on defib on 5th cycle of chest compressions

Stop CPR and move away from patient

Press shock button

57
Q

How should you respond to choking in an adult?

A

Ask “are you choking?”

Ask them to cough

Give 5 back blows = stand beside

In between shoulder blades

Check if food comes out in between blows

If no use, do abdo thrusts = stand behind

Fist between belly button and breast bone (dominant fist and other on top)

If no use do 5 more back blows

Unconscious = CPR

58
Q

How should you respond to choking child?

A

Hold child across arms length whilst holding onto the jaw to support their neck

Use heal of hand in between shoulder blades

5 back blows

Check for appearance of obstruction in between

If no use, use two fingers and apply force (poke) centre of child chest (5 blows)

Continue back and forth

For children little older use chest compressions moving upwards to dislodge