Instruments 2 Flashcards
What are the benefits of a definitive airway
- prevent ASPIRATION of gastric contents
- control of bventilation
- higher delivery of oxigen
benefit of non definitive airway
temporarily maintain aiirway patency
easy to insert
types of non definitive airway
LMA
OPA
NPA
types of definitive airway
endotracheal tube
tracheostomy
what is the function of a guedel
prevents tongue and pharynx soft tissues from obstructing the airway
– use if suspected airway compromise / snoring
complication of guedel airway
gagging
vomiting
laryngospasm if gag reflex intact
trauma to local structure
biting down may injure teeth
when is an NPA indicated
to provide an airway in people with suspected airway compromise or decreased levels of consciousness
or if mouth is diffiduclt to open e.g. seizure
or if laryngeal trayma
contraiindiczayions for NPA
basal skull fracture (CSF leak othorroea orr rhinorrhoea, haemotymnpanum, Battle sign, Racoon eyes)
facial /nasal fracture
nasal deformitiy
complications of NPA insertion
epistaxis
ulceration
insertion through criibiform plate into brain
indications for LMA
- elective procedure, low risk (alternative to endotracheal airway)
-cardiac arrest to secutre airway - prrehospital management
- rescue of failed intubation
benefits of LMA
- reduced trauma to oropharynx
- reduced hospital stay
- does not require laryngeal visualisation
contraaindication for LMA
-poor mouth opening
- pharyngeal or laryngeal obstruction
- intact gag reflex
complication of LMA
malposition
dislodgement
laryngospasm
ciugh
trauma to upper airway
indication for ET tube
trauma case
GCS <=8
surgery with GA
status epileptcus, rappuid sequence
when is miller blade (straight blade) of a laryngoscope used
in paediatrics
how long can a long term catheter be put in for
up to 3 months
indications for a surgicaal drain
drainage of a potential space post-surgery
removal of harmful fluid e.g. blood, bile, pus
detection of bleeding or leakage e.g. anastamosis
used in GI, ortho, plastics, cardiothoracics, breast, head and neck
how do you classify surgical drains
ACTIVE or PASSIVE
active drain - maintained under negative pressure, improves wound closure
passive drain - uses gravity, preferred in abdomen due to reduced risk of perforation
complications of surgcakl drains
Ascending infection (more common with open
or passive systems)
Foreign body reaction (fibrosis/granulation)
Migration
Obstruction/kinking
Fistulation
what materials can catheters be made up of and what is the difference
YELLOW = latex, short term
CLEAR = silicone, better for long term use
indications for urinary catheters
Urinary retention (acute or chronic)
Measurement of urine output in acute illness
During abdominal/pelvic surgery
Neurogenic bladder
Immobility (e.g. stroke)
End of life care
Urinary incontinence
Sacral or perineal ulceration
indications for absorbable vs non absorbable sutures
Absorbable: deep or rapid healing tissues e.g. bowel/biliary/urinary anastomoses
Non-absorbable: for permanent support and slower healing tissues e.g. vascular anastomoses,
tendon, fascia
what is a LAPAROSCOPIC TROCAR used for
used to create entry ports in laparoscopic procedures
INITIAL ENTRY CARRIES HIGHEST RISK OF PERFORATION
what is the gas of choice for laparoscopy and why
Carbon dioxide is the gas of choice
Inert, highly soluble in blood and tissues, rapidly cleared by expiration
