Implementation

Question 1

Pulmonary function test

Answer 1

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.

Question 2

Oral airway
- other names
- how is it measured
- what is it

Answer 2

• 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

Question 3

Nasal trumpet
- other names
- how is it measured
- use
- WOF

Answer 3

• aka nasopharyngeal airway
• measured from Tragus of the ear → tip of the nose + 1 inch
• uses: airway patency; nasopharyngeal suctioning
• problems: bleeding, sinusitis, erosion

Question 4

Laryngeal Mask Airway

Answer 4

• 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

Question 5

Laryngoscope

Answer 5

• Used for intubation

Question 6

Laryngoscope procedure

Answer 6

1. Ambubag for 1 min
2. Insert to expose vocal cords
3. Insert ET tube
4. 21cm should be aligned with incisors (gum line)

Question 7

How do you confirm ET placement?

Answer 7

• 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

Question 8

Overinflation of cuff will cause?

Answer 8

Tracheal erosion, tracheomalacia

Question 9

What is used for oral suctioning?

Answer 9

Yankauer suction catheter

Question 10

How long and how many times can you suction?

Answer 10

10-15 seconds max; 6-7 times PRN

Question 11

Simple face mask vs non-rebreather (/partial rebreather) mask

Answer 11

Partial rebreathers has no valve, exhalation ports are open
Also has reservoir which is always kept inflated

Question 12

Venturi mask colors and designated O2 levels?

Answer 12

[OPWYB]
Orange - 12L
Pink - 8L
White - 6L
Yellow - 4L
Blue - 2L

Question 13

How much FiO2 can an ambubag deliver?

Answer 13

100% if connected to oxygen source; 21% if not connected

Question 14

Oxygen toxicity happens when oxygen exceeds ?

Answer 14

2LPM

Question 15

Tracheostomy tube is for?

Answer 15

Long-term airway management (3 wks)

Question 16

Which type of trache tube allow pt to speak?

Answer 16

Fenestrated tracheostomy tube (with holes)

Question 17

Fenestrated tracheostomy tube is used to?

Answer 17

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

Question 18

Which 2 traches are used to facilitate weaning?

Answer 18

Fenestrated trache tube and T-piece

Question 19

What is T-piece for?

Answer 19

To wean pt off mech vent to breathing on their own

Question 20

Endotracheal Tube

Answer 20

• for temp access to mech vent (2-3 weeks)
• prevent VAP
• done at bedside

Question 21

ET tube sizing

Answer 21

Adults = 7-9mm ID

*usually bigger for M
*F usually 7

Question 22

Rapid Sequence Intubation

Answer 22

• 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

Question 23

Process of Rapid Sequence Intubation

Answer 23

• 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)

Question 24

What are the 2 techniques in rapid sequence intubation?

Answer 24

Minimal occlusive technique - prevent tracheomalacia

Minimal leak technique - aspirate little air until u hear air leak > disconnect > to prevent lung injury and tracheomalacia