Mgmt of airway and breathing

Question 1

what are top A and B priorities

Answer 1

patent airway and ventilation

Question 2

what is main goal of A and B

Answer 2

O2 in and CO2 out

Question 3

what is first question

Answer 3

is airway patent

Question 4

4 parts of normal airway

Answer 4

1. mouth/nose
2. oro/nasopharynx
3. larynx/glottis
4. trach

Question 5

3 possibilities when assessing airway patency

Answer 5

1. unobstructed
2. partial obs
3. complete obs

Question 6

what are signs of each obs

Answer 6

1. patient talking - patent
2. noisy breathing or gurgling - partial
3. no breathing - complete obs

Question 7

what does hoarseness mean

Answer 7

vocal cords affected

- can worsen rapidly, so need to beware

Question 8

3 ways to recognize obstuction

Answer 8

look
- resp effort
- chest rising
- indrawing
listen
- noisy breathing
- voice
feel
- for air via mouth and nose

Question 9

4 ways to manage an obst

Answer 9

1. sution - remove debris
2. jaw thrust/chin lift - pulls mandible and tongue forward
3. oroph/nasopha airway - pushes and keeps tongue forward
4. laryngeal mask airway

Question 10

what to do if these don’t work

Answer 10

laryngeal mask airway (LMA)

Question 11

what is LMA

Answer 11

• provides patent airway, but not protection from aspiration

- not a defninitve airway

Question 12

what is goal once patency is acheived

Answer 12

protect from aspiration as well

- definitive airway

Question 13

what is definitive airway

Answer 13

endotracheal tube

Question 14

what does ETT do (3)

Answer 14

1. patent airway
2. protection
3. able to deliver gas by pressure to lungs

Question 15

3 places and ETT can be inserted

Answer 15

Above cords
- ETT
Below cords
- cricothyroidotomy
- tracheostomy

Question 16

5 indications for a def. airway

Answer 16

1. patency
2. protection
3. O2
4. ventilation
5. pulm. toilet

Question 17

6 steps to intubation of a normal patient

Answer 17

1. sniffing pos.
2. 100% O2
3. anasthetic meds
4. ventilate
5. intubate
6. confirm correct placement of ETT

Question 18

6 ways to confirm airway is in the trachea

Answer 18

1. visualize with a scope
2. exhaled CO2 (gold standard)
3. chest rising
4. equal A/E
5. condensation on tube
6. bronchoscopy

Question 19

when to use CXR

Answer 19

AP does not confirm in thachea

- can be useful to see the position once you know it’s in

Question 20

7 things that are special in trauma PT for airways

Answer 20

1. emergent/urgent
2. altered LOC/ not cooperative
3. full stomach
4. possible C-spine
5. facial and airway traumas
6. hypovolemic
7. hypo oxemic

Question 21

how to manage C-spine

Answer 21

• assume it is damaged

- keep in a neutral position all the time

Question 22

3 levels of breathing

Answer 22

1. adequate
2. not at all
3. breathing but not adequate

Question 23

2 aspects to assessment of breathing

Answer 23

1. act/mechanics of breathing

2. diffusion of O2 and CO2 in alveoli

Question 24

3 ways to assess breathing

Answer 24

look
- rate/distress
- tidal vol
- symettry
listen
- to lungs
feel
- chest wall

Question 25

3 things to do if breathing aquately

Answer 25

1. apply O2 mask
2. apply o2 sat monitor
3. monitor

Question 26

3 things to do if not breathing

Answer 26

1. esure patency of airway
2. ventilate
3. figure out why apneaic

Question 27

3 things to do if patient not breathnig adequately

Answer 27

1. vent. of not adequate TV
2. intubate if not enough o2/COs
3. determine etiology

Question 28

5 locations that could cause inadequate ventilation

Answer 28

1. brainstem
2. cord
3. chest wall
4. pleura
5. lungs