Indications for intubation and extubation Flashcards

1
Q

What is the sniffing position?

A

Flexion of neck, extension of head

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2
Q

When intubating-always confirm

A

Presence of suction and free flowing IV line

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3
Q

What is FVC?

A

Forced vital capacity (FVC) is the amount of air that can be forcibly exhaled from your lungs after taking the deepest breath possible, as measured by spirometry

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4
Q

FEV:

A

How much a person can exhale in one breath

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5
Q

RSBI:

A

Frequecy/tidal volume (<60-100 breaths/min)

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6
Q

Subjective criteria for extubtion:

A

Resolution of acute disease
adequate cough
Patient should be awake, alert, and following commands
Cooperative
Sustained head lift >5 seconds
Able to tolerate spontaneous ventilation without excessive tachypnea, tachycardia, or obvious respiratory distress

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7
Q

Objective criteria for extubation: Vital signs

A

RR: <30-35 breaths/min
Stable BP with little to no ionotropic support
HR <140 bpm
Afebrile (temp <38)

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8
Q

Objective criteria for extubation: ABG

A
ABG on 40% FiO2 and PEEP less thanor equal to  (5-10) 
PaO2 >60 
PaCO2 <55 
PaO2/FiO2 ratio >150-300 (200) 
AA gradient <350 
Maintenance of normal pH (>7.30)
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9
Q

Objective criteria for extubation: Mechanincal function

A
FVC >10-15 
FEV 1 >10 
Tidal Volume >4-6 mL/kg 
NIF >20 
RSBI <60-100 

*adequate hemoglobin and obviously no significant respiratory acidosis

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10
Q

Indications for intubation: mechanical function

A

RR >35
VC <15 mL/kg (adult)
VC <10 mL/kg (child)
NIF less than 20-25 cm

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11
Q

Indications for intubation: gas exchange function

A

PaO2 <60%
PaCO2 >/ 55 unless chronically elevated
Dead space ventilation/tidal volume (Vd/Vt) ratio >/0.6 (normal 0.3)

Unstable vital signs

*obviously the inability of the patient to protect his airway secondary to agitation, airway burns, neuro injury

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