Implementation Flashcards
Pulmonary function test
Measures O2 and CO2 with inhalation and exhalation. Done outpatient for diagnosis of ppl w chronic respiratory disease. Can determine pt’s response to therapy also.
Oral airway
- other names
- how is it measured
- what is it
- AKA Oropharyngeal airway, bite block, tongue guard
- from tip of mouth to tragus (end of jaw); ask for patient’s height prior (and if may dentures)
- for: tongue relaxation, suctioning secretions. Seizures, biting down on ET; when pts are unconscious their tongues roll back and block their airway so this opens it up
Nasal trumpet
- other names
- how is it measured
- use
- WOF
- aka nasopharyngeal airway
- measured from Tragus of the ear → tip of the nose + 1 inch
- uses: airway patency; nasopharyngeal suctioning
- problems: bleeding, sinusitis, erosion
Laryngeal Mask Airway
- Temporary means of intubation
- Has rubber that you can glide on the tongue for easier intubation
- Seen in ER and OR
- Used if pt has bronchospasms; and for COVID pts
Laryngoscope
- Used for intubation
Laryngoscope procedure
- Ambubag for 1 min
- Insert to expose vocal cords
- Insert ET tube
- 21cm should be aligned with incisors (gum line)
How do you confirm ET placement?
- Assess through auscultation
- If di equal ang breath sounds (unilateral breathing), then the tube is inserted too much kasi it might’ve been inserted in the right bronchi which is shorter
- mark position of tube at the lip
- SPO2
- CXR (2-4 in above carina)
How to address
- Deflate cuff then pull 1-2in then inflate cuff
Overinflation of cuff will cause?
Tracheal erosion, tracheomalacia
What is used for oral suctioning?
Yankauer suction catheter
How long and how many times can you suction?
10-15 seconds max; 6-7 times PRN
Simple face mask vs non-rebreather (/partial rebreather) mask
Partial rebreathers has no valve, exhalation ports are open
Also has reservoir which is always kept inflated
Venturi mask colors and designated O2 levels?
[OPWYB]
Orange - 12L
Pink - 8L
White - 6L
Yellow - 4L
Blue - 2L
How much FiO2 can an ambubag deliver?
100% if connected to oxygen source; 21% if not connected
Oxygen toxicity happens when oxygen exceeds ?
2LPM
Tracheostomy tube is for?
Long-term airway management (3 wks)
Which type of trache tube allow pt to speak?
Fenestrated tracheostomy tube (with holes)
Fenestrated tracheostomy tube is used to?
to wean pt off trache so they can breathe on their own; the holes can close with a button which teaches them to breathe through their nose
Which 2 traches are used to facilitate weaning?
Fenestrated trache tube and T-piece
What is T-piece for?
To wean pt off mech vent to breathing on their own
Endotracheal Tube
- for temp access to mech vent (2-3 weeks)
- prevent VAP
- done at bedside
ET tube sizing
Adults = 7-9mm ID
*usually bigger for M
*F usually 7
Rapid Sequence Intubation
- for pts experiencing respi distress, apnea, pulmo edema (or other w ineffective clearance of secretions)
- earliest sign of hypoxia: restlessness
- initial intervention for hypoxia: raise HOB, DBE, administer O2
Process of Rapid Sequence Intubation
- only done by doctor
- hyperextend neck & hyperoxygenate muna
- usual size: Fr 6-7 for adults; ^ Fr = ^ diameter
- dapat may bilateral chest expansion (4 quadrants I check mo)
- use 10cc syringe to inflate balloon (not for anchoring but to prevent air leak)
What are the 2 techniques in rapid sequence intubation?
Minimal occlusive technique - prevent tracheomalacia
Minimal leak technique - aspirate little air until u hear air leak > disconnect > to prevent lung injury and tracheomalacia
