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TRAUMA > Management of a trauma patients air way > Flashcards

Management of a trauma patients air way Flashcards

1
Q

What are the components of the Upper Airway?

A
  1. Nasal Cavity
  2. Pharynx ( Naso, Oro, and Hypo.)
  3. Larynx
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2
Q

What are the components of the LOWER Airway?

A
  1. Trachea
  2. Left and Right mainstem bronchi
  3. Further sub-divsions
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3
Q

What is the primary involuntary respiratory center?

A

Medulla

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4
Q

What part of the brain is connected to the respiratory muscles by the Vagus nerve?

A

The Pons

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5
Q

The Cerebrospinal Fluid pH is controlled by what?

A

Respiratory Center stimulations

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6
Q

What happens when an increase of Partial pressure (Pa) of Carbon Dioxide results in a DECREASE of cerebral spinal fluid pH ( More acidic) which results in an increase in?

A

Respirations

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7
Q

what is a late homeostatic system designed to increase respiration rate and depth (tidal volume) when the body material oxygen levels (SaO2) decreased significantly?

A

The hypoxic Drive

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8
Q

What would INCREASE respirations in the body?

A
  1. Body Temp.
  2. Emotion
  3. Pain
  4. Hypoxia
  5. Acidosis
  6. Stimulant drugs
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9
Q

What would DECREASE respirations in the body?

A
  1. Depressant drugs, sleeping agents
  2. Drugs like morphine
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10
Q

What is the term for when there is no oxygen available at all?

A

Anoxia

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11
Q

What does SaO2 stand for?

A

Arterial Oxygen Saturation

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12
Q

What does PaO2 stand for?

A

Arterial Oxygen Tension

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13
Q

What is room air FiO2 equal to?

A

21%

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14
Q

What literally means “deficient in oxygen”, which is an abnormally low oxygen availability to the body or an individual tissue or organ?

A

Hypoxia

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15
Q

What is defined as insufficient oxygen; that is decreased partial pressure of oxygen in the blood?

A

Hypoxemia

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16
Q

What is a non-invasive method allowing the monitoring of the saturation of a patient’s hemoglobin?

A

Pule Oximeter

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17
Q

What are the indications for O2 therapy? (5)

A
  1. Cardiac and respiratory arrest
  2. Hypoxemia (pO2< 58.5 mmHg, Sat < 90%)
  3. Hypotension ( Systolic BP < 100 mmHg)
  4. Low Cardiac Output and Metabolic Acidosis (serum bicarbonate < 19 mmol/l)
  5. Respiratory distress ( RR > 24 Min)
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18
Q

What are the types of oxygen delivery devices? (6)

A
  1. Pocket Mask
  2. Nasal Cannula
  3. Bag-valve Mask
  4. Non-rebreather Mask
  5. Ventilators
  6. Hyperbaric Oxygen
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19
Q

The Non-rebreather mask is utilized for patients with the following conditions?

A
  1. Physical Trauma
  2. Chronic Airway limitation/ chronic obstructive pulmonary disease
  3. Cluster headache
  4. Smoke inhalation
  5. Carbon Monoxide Poisoning
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20
Q

What are the Manual Airway Maneuvers? (6)

A
  1. Manual Clearing of the airway (finger sweep)
  2. Manual Maneuvers
  3. Head tilt/chin lift
  4. Jaw Thrust Maneuver
  5. Sellick’s Maneuver
  6. BURP
21
Q

What is the common cause of airway obstruction?

A

Tongue

22
Q

What maneuvers are used on patients with suspected head, neck, or facial trauma, the cervical spineis?

A

Jaw Thrust

23
Q

What maneuvers are used with BVM, and aid in preventing aspiration, by applying gentle posterior pressure to the patient’s cricoid cartilage?

A

Sellick’s Maneuver

24
Q

How is the BURP maneuver conducted?

A

Back-ward, Up-ward, Right-ward Pressure (BURP)

25
Q

What are the two Advanced Airway Devices? (8)

A
  1. Oropharyngeal Airway (OPA)
  2. NPA
  3. Endotracheal Intubation
  4. Esophageal Tracheal Combitube Airway ( Double Lumen)
  5. Laryngeal Mask Airway (LMA)
  6. Laryngeal Tube Airway (LTA)
  7. Surgical Cricothyrotomy
    8.
26
Q

What is the most frequently used airway device?

A

OPA

27
Q

What are the indications for the use of OPA?

A
  1. Casualty who are unable to maintain their airway
  2. Casualty whose tongue continues to fall into the back of the pharynx causing airway obstruction.
  3. To assist in improving ventilation in patients that are being ventilated with a BVM.
  4. It also prevents an intubated casualty from biting an ET tube
28
Q

What are the contraindications for OPAs?

A

Casualty who is conscious or semiconscious

29
Q

What are the complications of using OPA(s)?

A
  1. Due to gag reflex stimulation
  2. Use of the OPA may lead to gagging, vomiting, and Larynogasm in casualties who are conscious.
30
Q

What are the disadvantages of the NPA include?

A
  1. its smaller size
  2. The risk of nasal bleeding during insertion
    *3. The NPA cannot be used if a basilar fracture is suspected.
31
Q

What are the Contraindications for NPA(s)?

A
  1. No need for an airway adjunct
    *2. Suspected basilar skull fracture.
32
Q

What are the Complications for NPA(s)?

A
  1. Bleeding caused by insertion may be a complication
  2. Inserting the NPA into the brain with a basilar skull fracture.
  3. Nasal turbinate injury.
33
Q

When using an I-gel what is a big concern?

A

TACEVAC on an aircraft

34
Q

According to ATLS preferred definitive airway is tracheal intubation through the mouth using direct laryngoscopy?

A

Endotracheal Intubation

35
Q

What are the Indications of Endotracheal Intubation?

A
  1. Unable to protect the airway.
  2. Signifanct oxygenation problem, requiring administration of high concentrations of oxygen
  3. Casualty with significant in ventilation requiring assisted ventilation.
  4. Cardica arrest.
  5. Severe hemorrhagic shock
36
Q

What are CONTRAINDICATIONS for use of Endotracheal Intubation?

A
  1. Patient with epiglottitis
  2. Lack of training in technique
  3. Lack of proper indications
  4. obstruction of the upper airway due to foreign objects
  5. Cervical fractures
37
Q

the following conditions require caution before attempting to intubate with Endotracheal Intubation?

A
  1. Ingestion of caustic substance
  2. Mandibular fractures
  3. Laryngeal edema
  4. Thermal or chemical burns
38
Q

What are the COMPLICATIONS of using Endotracheal Intubation?

A
  1. Hypoxemia from prolonged intubation attempts
  2. Trauma to the airway with resultant hemorrhage
  3. Right mainstem bronhus intubation
  4. Esophageal intubation
  5. Vomiting leading to aspiration
  6. losses or broken teeth
  7. Injury to vocal cords
  8. Conversion of a cervical spine injury without neurological to one with neurological deficit.
39
Q

When using suction how long should it only be done for?

A

15 secounds

40
Q

What are the indications for Laryngeal Mask Airway (LMA)?

A

When unable to perform endotracheal intubation and the casualty cannot be ventilation using a BVM device.

41
Q

What is the Contraindications Laryngeal Mask Airway (LMA)?

A
  1. When endotracheal intubation can be performed
  2. Insufficient Training
42
Q

What are the Complications of Laryngeal Mask Airway (LMA)?

A
  1. Aspiration
  2. Laryngospasm
  3. Sore Throat
43
Q

The primary purpose of a cricothyroidotomy is to provide an emergency breathing passage for a patient whose airway is closed by what?

A
  1. Traumatic injury to the neck
  2. By burn inhalation injuries
  3. By closing of the airway due to an allergic reaction to bee or wasp stings
  4. Or by inconsciousness
44
Q

What are the two basic types of cricothyroidotomy?

A
  1. Needle Cricothyrotomy
  2. Surgical Cricothyrotomy
45
Q

What are the INDICATIONS for cricothyrotomy?

A
  1. Massive midface trauma precluding the use of BVM device.
  2. Inability to control the airway using less invasive maneuvers.
  3. Ongoing tracheobronchial hemorrhage.
46
Q

What are the Contraindications for Cricothyrotomy?

A
  1. Any casualty who can be safely intubated, either orally or nasally.
  2. Casualties with laryngotracheal injuries.
  3. Children under the age of 10 years of age.
  4. Casualties with the acute laryngeal disease of traumatic or infectious origin.
  5. Insufficient Training
47
Q

What are COMPLICATIONS cricothyrotomy?

A
  1. Prolonged procedure time
  2. Hemorrhage
  3. Aspiration
  4. Misplaced or false passage of the ET tube
  5. injury to the neck structures or vessels
  6. Perforation of the esophagus
  7. The longer the period of use the greater the risk of complications.
48
Q

How long can a surgical cricothyroidotomy be left in place for about how long?

A

24 hours

TRAUMA (15 decks)

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