Module 4 Flashcards
endotracheal tube considerations:
- mucosal
- injury to
- tracheal
injury
vocal folds
edema, ulceration and stenosis
Clinical complications of cuff: tracheal wall esophageal ... laryngeal
injury
impingement
backflow
tethering
Physiologic changes after tracheotomy: speech taste and smell -reduced PEEP negatively impacts 1. 2. 3. body 4.
physiologic peep
swallow
body core and strength posture
cough
physiologic changes after trach. inability to control secretions due to -decreased -pooling of -loss of
cough effort
secretions
pharyngeal and laryngeal sensations
-
delays or decrease using PMV
- cooing
- babbling
Benefits of closing the system: restores -improved -improved -decreased risk of
physiologic positive pressure
- gas exchange
- oxygen saturation levels
- risk of atelectasis
Role of pressure: - - - - - -..control -.. stability
breathing coughing swallowing voicing mobility -trunk control -postural stability
Expedites weaning and decannulation:
rehabilitation
-for
-for
step toward ?
- less work of
- develops ?
tool
- respiratory muscles
- upper airway muscles
- decannulation
- breathing vs. capping
- confidence and motivaiton
Pocket TOM: assess upper airway patency do what first ask patient to ... next?
deflate cuff
inhale
finger occlude and speak or cough on exhalation
Transitioning and troubleshooting: excesive air ? need for .. rehab ..isues
coughing air trapping, back pressure retraining laryngeal/pharyngeal muscle rehab psychological issues
Factors affecting expiraotry air flow: size or type of presence and degree of ... ... incomplete ... cuff tube ?
trach tube obstruciton edema secretions cuff defaltion foam filled cuff tube position
Troubleshooting;
downsize or different brand tube
Therapy goal areas: valve use during waking hours with? .. management reestablish speech and language ...
spo2>90%
swallowing and secretion management
inta-oral airflow management
development
decannulation
Trach and aspiration: does a cuff prevent aspiration -incidence of aspiration ... apsirate silent aspiration up to ?
high correlation of
45-86%
83%
aspiration around the cuff
secretions and aspiration
Cuffed inflated condition:
-significantly greater frequency of ?
significantly less ?
higher the cuff pressure the more negative effect on?
research is ? and methods not ?
silent aspiration in cuff inflated condition
hyolaryngeal elevation during swallow
swallowing
variable/strong
pharyngeal deficits: common interventions ..exercises ...maneuver ...swallow ...maneuver ...swallow ....
falsetto exercises mendelsohn maneuver supraglottic swallow shaker maneuver effortful swallow masako
prior to covid patients were typically intubated ? but with covid ?
longer intubation leads to greater ?
7-10 days / intubated much longer
muscle disuse atrophy
with endotracheal tube removed patient can move ? and.. can be provided more thoroughly
tongue
oral hygiene
when is pediatric trach tube utilized ? rather than infant size
3 years
check amount of cuff inflation with ?
goal is ?
who does this ?
manometer
20-30 cm of water
respiratory therapy
PEEP: air in the lungs that remains ? PEEP... with cuff inflation can lead to some ? atelectasis: a condition where the
after exhalation (lungs never fully deflate)
levels drop
alveoli of lung not fully inflated
when placing PMV apply and twist ? this serves to avoid ? and accidental removal of ?
1/4 to right
pressure on trach tube/trach tube if there is reusable inner cannula