Exam 1 Part 4 Flashcards
1
Q
Extubation Criteria:
When do we take the tube out?
A
- airway protective reflexes intact
- intact neuro function
- normal body temp 35-37C
- normal coagulation
2
Q
When to extubate–the signs: twitch monitor
A
- head lift, grip, TOF 4/4, sustained tetany (5 secs
3
Q
When to extubate–the signs: TV
A
TV > 5ml/kg
4
Q
When to extubate–the signs: PaO2 and FiO2
A
PaO2 > 65
FiO2 < 0.4
5
Q
When to extubate–the signs: PaCO2
A
50 torr
6
Q
When to extubate–the signs: resting MV
A
MV < 10 l/min
7
Q
Immediate hazards of extubating:
A
Laryngospasm
Vomiting
Hypoxia/loss of airway
8
Q
Deep extubation contraindications:
A
- difficult mask airway
- difficult intubation
- aspiration risk
- airway edema
9
Q
Why deep extubation?
A
- minimize tracheal stimulation
- minimize coughing/bucking to keep IOP, ICP, BP low
10
Q
Deep extubation criteria:
A
- MAC 1.3
- NMB is completely reversed
- Spontaneous ventilation at regular rate/rhythm
- No airway reflexes
- 100% O2
- Lidocaine (0.5/kg)
11
Q
Never extubate a patient without an oral airway in place. True or false?
A
True
12
Q
After you extubate a patient: (5)
A
- suction one more time
- mask patient
- keep hand on bag
- test for airway patency
- help them breathe
13
Q
Awake tracheal extubation: DO NOT extubate until judged to protect their airway
A
- patient breathing, 100% oxygen
- consider OAW/NAW/bite block
- suction
- verify patient status
- deflate cuff
- PPV with bag
- remove tube
14
Q
ASA standards for PACU Standard I
A
anesthesia team and PACU are available
15
Q
ASA standard II for PACU
A
- patient transported to PACU with someone knowledgeable about patient
- patient shall be continually evaluated and treated during transport with monitoring and support appropriate to the patient’s condition
