Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CBRC > Manage LMA > Flashcards

Manage LMA Flashcards

1
Q

Pharyngeal Airways

A

Devices used to elevate the tongue off the posterior pharyngeal walland away from the hard and soft palates, thereby establishing a patent airway through which spontaneous ventilation can be achieved.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Oropharyngeal Airways (OPAs)

A

´Rigid, curved device with an air passage, placed through the mouth with end resting distal to the tongue above the glotticopening.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

OPA Indications For Use

A
  • Used in patients with decreased submandibulartone
    • Obtunded 2° to any of the central causes of airway obstruction
    • Anaesthesia
    • Deep sedation
  • Used when manually ventilating a patient
  • Used as aid for deep suctioning
  • Used as a bite block (careful!!)
  • Some models used to facilitate intubation
  • Neonates (specific)
    • Bilateral ChoanalAtresia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Contraindications to OPA

A

´Patients with obvious oral trauma

´Awake or semi-conscious patients

´May cause gagging and/or vomiting

Important: If a patient is awake enough to spit or tongue the device out, they are too awake for this device to be used.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

OPA Size

A

´Proper size estimated by placing airway next to face, with flange at mouth, tip of airway should reach angle of jaw (tragus of ear)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Complications from use of OPAs

A

´May cause trauma to lips, mouth and/or teeth

´May cause pressure necrosis

´Difficult to perform mouth care

´May cause gagging and vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Nasopharyngeal Airways (NPAs)

A

aka… nasal trumpet

Soft or semi-rigid hollow tube placed through the nares, the tip lying distal to the tongue above the glotticopening.

May be sized in mm I.D. or French sizes

Measure corner of mouth to jaw angle

Length is more critical than diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Indications for NPA

A
  • Semi-awake patients who still require some airway maintenance who do not tolerate an OPA
  • May be used when insertion of OPA is difficult or contraindicated
  • Maybe used to facilitate deep suctioning
  • Pierre-Robin Syndrome (in neonates)
    • Micrognathia
    • Mandibular hypoplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Contraindications for NPA

A

´Obvious nasal trauma

´Deformities of the nose

´Basal skull fractures

´Raccoon eyes

´Battle’s sign

Coagulation disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Raccoon Eyes

A

Ecchymoticareas surrounding both eyes, suggestive of a basilar skull fracture or childhood neuroblastoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Battle’s Sign

A

Skull fractures are common in children and result from accidents (the majority are automobile or auto/bike accidents) or abuse.

Battle’s sign is seen several days following a basilar skull fracture.

There may have been bloody drainage from the ear immediately after the fracture occurred.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

NPA Complications

A

´If too long, it may enter esophagus causing gastric distension and hypoventilation

´May cause vomiting and laryngospasm in semi- conscious patient

´Injury of nasal mucosa with bleeding

´Sinusitis

´Otitis media

´Intubation of meninges (basal skull fracture)

´Occlusion of airway by secretions

´Tissue necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

General Indications Extraglottic Airways

A

Airway Rescue Device

BMV and intubation have failed

During or in preparation of a cric

Easier than BMV and alternative to intubation (OR)

Help facilitate intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Two Main Classes of Extraglottic Airways

A

1) Supraglottic- Above the glottis
2) Infra/retroglottic-Behind and/or beyond the glottis. Devices that are intended to be placed in the esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Supraglottic Airways

A

´LMA classic

´LMA FastTrach

´LMA Proseal

´PerilaryngealAirway

´iGel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Laryngeal Mask Airways
“Classic”

A

Similar to ETT but with a small mask and inflatable circumferential cuff

Place in posterior pharynx in order to seal the region at the base of the tongue and laryngeal opening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Laryngeal Mask Airways “Classic”

Contraindications

A

´Patients with full stomachs

´Patients with hiatalhernia

´Patients who are more than 14 weeks pregnant

´Trauma patients

18
Q

Laryngeal Mask Airways “Classic”

LArge Adult Size

A

5

19
Q

Laryngeal Mask Airways “Classic”

Normal Adult kg Size

A

4

20
Q

Laryngeal Mask Airways “Classic”

Child >30 kg Size

A

3

21
Q

Laryngeal Mask Airways “Classic”

Infant 20-30 kg Size

A

2.5

22
Q

Laryngeal Mask Airways “Classic”

Infant <20 kg Size

A

2

23
Q

Laryngeal Mask Airways “Classic”

Neonate Size

A

1

24
Q

Advantages of Laryngeal Mask Airway

A

Simple and easy to teach. Easily inserted

Does not require airway manipulation or extreme head positioning

More effective than oropharyngealor nasopharyngeal airways

Can be cleaned and reused (yuk)

‘Hands Free’ airway management

´Good for short procedures requiring anesthesia or deep sedation

´Someprotection of airway from aspiration

´Can aid in difficult intubation

´15 mm connector for resuscitator

´Provides route for fiberopticlaryngoscopy or bronchoscopy

25
Q

Drawback of Laryngeal Mask Airway

A

´Expensive (relative)

´Standard sizes may not fit correctly

´Does not prevent aspiration completely

´Pressures > 20 cmH2O can lead to ventilation volume loss and gas leak around mask/cuff

26
Q

Complications of Classic Laryngeal Mask Airway

A

´If LMA too small, may enter esophagus

´Airway patency lost if LMA becomes dislodged or twisted

´Gag reflexes that are intact will cause coughing, straining and spasm (solved by anesthesia)

´Failure to pass mask downward behind tongue (caused by inadequate neck flexion or incomplete mask deflation)

´Regurgitation and aspiration

´Tip of LMA may become folded over on insertion

´Epiglottis may become folded over and obstruct glottis

´Patient may complain of sore throat if cuff is over-inflated

27
Q

Laryngeal Mask Airways
“Fastrach”

A

´Aka… an IntubatingLMA (ILMA)

´Combines the high insertion and ventilation success rates of other LMAs with specially designed features to facilitate blind intubation.

´An epiglotticelevating bar

´A rigid guide channel that directs an ETT anteriorlyinto the larynx

´Comes in both re-usable and disposable models

28
Q

Laryngeal Mask Airways “Proseal”

Used Where

A

Not commonly used in emergent care settings

29
Q

Why choose a LMA proseal?

A

Double tube for seperation of repiratory and GI tract, which will reduce mask rotation or displacement and secure hands free anesthesia

Larger sizes provide better seal than classic LMA for a given intracuff pressure, and the airway seal pressure will be over a greater area which results in higher seal at lower pressure

Allows ventilation at higher pressures

Built in bite-block that reduces the risk of airway obstruction or tube damage

30
Q

Why is an independent open-drain tube desirable?

A

Opening at upper esophgeal sphincter

  • Drain gastric fluid-help prevent aspiration
  • Access GI tract-Blind insertion of OG
  • Escape route for inspired gas-Prevtn gastic insufflation
  • Prevent epiglottis from occluding airway-Eliminating need for aperature bars
31
Q

Perilaryngeal Airway

A

Aka…Cobra PLA or Cobra

Consists of:

1) Breathing tube
2) Circumferential cuff
3) Distal “Cobra” head

32
Q

Perilaryngeal Airway

Breathing Tube

A

´Large diameter

´15 mm adapter

33
Q

Perilaryngeal Airway

´Circumferential cuff

A

Shaped to reside in the hypopharynx at the base of the tongue

When inflated raises the base of the tongue to expose the laryngeal inlet

34
Q

Perilaryngeal Airway

Distal “Cobra” Head

A

Hold apart the soft tissue to allow trachea ventilation

Will help to direct epiglottis and is flexible enough to allow passage of ETT

Ramp inside head directs breathing gases into trachea

35
Q

Perilaryngeal Airway Sizes

A

8 Sizes- according to weight

36
Q

Infra(Retro)glottic Airways

A

Intended to be inserted blindly into the esophagus, but still provides an airway if inserted into trachea

Combitube

RuschEasy Tube

King LT-D

37
Q

Combitube

A

Double lumen tube

Distal and proximal cuffs (seperate pilot tube)

Allow tube to provide tracheal ventilation regardless of whether it is in the esophagus or trachea

38
Q

Combitube

Double Lumen

A

´one channel (tracheal tube) has a distal stopper (closed at distal end)

´other channel (esophageal tube) is open at the distal end

´Tubes separated by partition wall

´Combined outer diameter 13mm

39
Q

Combitube

Distal and Proximal Cuffs

A

Distal cuff is designed to seal the esophagus when placed correctly and seal the trachea when incorrectly placed

Proximal cuff will seal oropharynx

Laryngeal aperture (group of holes) is found in esophageal tube between two cuffs

40
Q

Combitube Sizes

A

´Two sizes

´37 Fr –for small adults (4’ to 5 .5’ tall)

´41 Fr – for adults greater than 5.5’ tall

´No sizes available for patients (ie. Peds) under 4’ tall

41
Q

Infra(Retro)glotticAirways
EasyTube

A
  • ´Insertion and verification are the same as for the combitube
  • ´Double cuff system
    • ´Proximal (pharyngeal) cuff seals oropharynx
      • Non-latex
    • Distal (esophageal) cuff seal esophagus … or trachea
  • Double lumen above proximal cuff
  • Single lumen below proximal cuff
    • Smaller diameter-can be inserted in smaller patients
  • Esophageal lumen opens just belowproximal cuff
    • Fibrotic scope, suction catheter or tracheal introducer may be passed through when tube is situated in the esophagus
42
Q

EasyTube Sizes

A

Two sizes

28F may be used in small adults and older children

41F

CBRC (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions