Mgmt of airway and breathing Flashcards

1
Q

what are top A and B priorities

A

patent airway and ventilation

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2
Q

what is main goal of A and B

A

O2 in and CO2 out

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3
Q

what is first question

A

is airway patent

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4
Q

4 parts of normal airway

A
  1. mouth/nose
  2. oro/nasopharynx
  3. larynx/glottis
  4. trach
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5
Q

3 possibilities when assessing airway patency

A
  1. unobstructed
  2. partial obs
  3. complete obs
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6
Q

what are signs of each obs

A
  1. patient talking - patent
  2. noisy breathing or gurgling - partial
  3. no breathing - complete obs
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7
Q

what does hoarseness mean

A

vocal cords affected

- can worsen rapidly, so need to beware

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8
Q

3 ways to recognize obstuction

A
look
- resp effort
- chest rising
- indrawing
listen
- noisy breathing
- voice
feel
- for air via mouth and nose
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9
Q

4 ways to manage an obst

A
  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
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10
Q

what to do if these don’t work

A

laryngeal mask airway (LMA)

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11
Q

what is LMA

A
  • provides patent airway, but not protection from aspiration

- not a defninitve airway

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12
Q

what is goal once patency is acheived

A

protect from aspiration as well

- definitive airway

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13
Q

what is definitive airway

A

endotracheal tube

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14
Q

what does ETT do (3)

A
  1. patent airway
  2. protection
  3. able to deliver gas by pressure to lungs
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15
Q

3 places and ETT can be inserted

A
Above cords
- ETT
Below cords
- cricothyroidotomy
- tracheostomy
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16
Q

5 indications for a def. airway

A
  1. patency
  2. protection
  3. O2
  4. ventilation
  5. pulm. toilet
17
Q

6 steps to intubation of a normal patient

A
  1. sniffing pos.
  2. 100% O2
  3. anasthetic meds
  4. ventilate
  5. intubate
  6. confirm correct placement of ETT
18
Q

6 ways to confirm airway is in the trachea

A
  1. visualize with a scope
  2. exhaled CO2 (gold standard)
  3. chest rising
  4. equal A/E
  5. condensation on tube
  6. bronchoscopy
19
Q

when to use CXR

A

AP does not confirm in thachea

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

20
Q

7 things that are special in trauma PT for airways

A
  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
21
Q

how to manage C-spine

A
  • assume it is damaged

- keep in a neutral position all the time

22
Q

3 levels of breathing

A
  1. adequate
  2. not at all
  3. breathing but not adequate
23
Q

2 aspects to assessment of breathing

A
  1. act/mechanics of breathing

2. diffusion of O2 and CO2 in alveoli

24
Q

3 ways to assess breathing

A
look
- rate/distress
- tidal vol
- symettry
listen
- to lungs
feel
- chest wall
25
Q

3 things to do if breathing aquately

A
  1. apply O2 mask
  2. apply o2 sat monitor
  3. monitor
26
Q

3 things to do if not breathing

A
  1. esure patency of airway
  2. ventilate
  3. figure out why apneaic
27
Q

3 things to do if patient not breathnig adequately

A
  1. vent. of not adequate TV
  2. intubate if not enough o2/COs
  3. determine etiology
28
Q

5 locations that could cause inadequate ventilation

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