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Airway management test review > Module 4 airway management test > Flashcards

Module 4 airway management test Flashcards

review

1
Q

which patient requires a nasal cannula over a non-rebreather mask?

A

90-93% per Nancy caroline.

A patient who only requires a little supplemental oxygen to maintain normal ranges.

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2
Q

D tank psi (constant flow 0.16)

A

2000 psi

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3
Q

H tank psi (Constant flow 3.14)

A

7000 psi

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4
Q

Duration of flow formula

A

(tank pressure in PSI – 200) x cylinder conversion factor
———————————————————– L/minute
= time until cylinder is empty flow

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5
Q

Breakfast question: After a call for motorcycle crash, your partner asks you to defend your reasoning for ignoring the patient’s broken leg. What is the most appropriate reasoning?

A

Problem protecting airway.

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6
Q

Which of the following is true regarding cricoid pressure maneuvers?

A

A maneuver performed to prevent regurgitation. Apply Back, Up, Right Pressure (BURP) closes off esophagus and helps with visualization of vocal cords for ET intubation.
Sellick maneuver.

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7
Q

Lung sound: Wheezes

A

Lower airway/bronchoconstriction. Unilateral wheezing indicates aspirated FBAO, bilateral suspect asthmas.

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8
Q

Lung sound: Crackles

A

Lower airway; indicates cardiac failure and infection.

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9
Q

Lung sound: Stridor

A

Narrowing, swelling or obstruction of upper airway, indicates FBAO, epiglottitis, croup and airway burns.

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10
Q

Lung sound: Rhonchi

A

Fluid in the upper airway, indicates inflammation or infection.

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11
Q

Snoring respirations

A

Airway obstruction of the tongue

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12
Q

Which would be a common complication when sedating a patient prior to intubation:

A

Common complications are primarily associated with oversedation and undersedation.

Undersedation results in inadequate patient cooperation, gagging complications (trauma, tachycardia, HTN, vomiting, aspiration), incomplete amnesia of event.

Oversedation results in uncontrolled anesthesia, loss of protective airway reflexes, respiratory depression, complete airway collapse and hypotension.

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13
Q

Which of the following would negatively affect alveolar diffusion?

A

Pulmonary edema, restrictive pulmonary circulation disease.

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14
Q

There is vomit found in a supine unconscious trauma patient. What is the priority?

A

Remove vomit by rolling the patient on his side while maintaining c-spine, followed by suctioning as needed.

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15
Q

Which age group has the higher risk for FBAO?

A

Typical victim is middle-aged or older, wears dentures, has consumed alcohol.

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16
Q

ETT tube sizes based on age and how to find the size:

A

Duracher’s formula: (age/4) + 3.5
This formula is for cuffed ET tubes in ages after 2 and older.
Uncuffed ETT= (Age/4) + 4.

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17
Q

Esophageal tracheal dual lumen airway:

A

Combitube: supraglottic airway with two lumens. One lumen is for ventilation, the other blocks the esophagus or trachea. Inserted blindly. Used when other attempts at intubation fail. Complications include vomiting, aspiration, dental trauma, tongue edema.

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18
Q

Which of the following is a contraindication for surgical cric but good for needle cric?

A

Surgical cricothyrotomy is contraindicated for pediatrics under 8, needle cricothyrotomy is indicated for 1-8 year olds.

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19
Q

What would you do to improve FiO2 level for a ventilated not spontaneously breathing patient?

A

Contact medical control, Adjust PEEP.

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20
Q

Digital intubation:

A

Also known as tactile orotracheal intubation, procedure that can be used by paramedics to insert a tube into a patient’s larynx. Blind technique, airway isn’t directly visible.
-involves inserting a tube into a patient’s airway using your fingers to feel for the epiglottis. It should only be used on patients who are unconscious or paralyzed.

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21
Q

Breakfast question: Which of the following is the most serious sign in a pediatric patient with an airway problem?

A

Decreasing heart rate.

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22
Q

Most accurate statement regarding ETDLA’s in trauma patients:

A

Not first line intervention for airway control. Contraindicated in the case of trauma of the head, neck and airway.

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23
Q

Suctioning of patient’s in cardiac arrest:

A
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24
Q

Which of these devices has a negative impact on peep?

A

LMA

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25
Q

You are treating a pediatric trauma patient. your patient’s HR drops precipitously, what has happened to cause this sudden change?

A

Respiratory failure, hypovolemia

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26
Q

How to work with pediatric apneic chocking patients?

A

Start CPR, 1 rescuer is 15:2/2 rescuer is 30:2. When going to give ventilations look in the airway prior to ventilation to see if the airway obstruction is visible and can be removed with Magill forceps. Remove the obstruction if possible.

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27
Q

True statement regarding infants airway:

A

Tongues are proportionately larger than adults, shorter.

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28
Q

During transport of an active resuscitation of a traumatic arrest on an automatic transportation ventilator, you do not feel carotid pulses and note patient’s color has not improved. Most likely there is no change in this because:

A

Inadequate chest compressions.

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29
Q

Differences between pediatric and adult airways:

A

The pediatric airway is smaller in diameter and shorter in length than the adult’s. The young child’s tongue is relatively larger in the oropharynx than the adult’s. The larynx in infants and young children is located more anteriorly compared with the adult’s.

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30
Q

your partner is ventilating 60 times for a 1 year non intubated patient, what is most likely to occur?

A

Gastric distension.

31
Q

Sizing OPA and NPA:

A

OPA: measure from corner of mouth to tragus.
NPA: measure from corner of nostril to tragus.

32
Q

Suctioning through an ET tube:

A

Measure the depth of suction from the sternal notch up around the ear and to the corner of the nostril. Prep the suction to 300 mm Hg over 4 seconds and set the suction to 100 mm Hg so as to not damage internal tissues. Lower the suction into tube and withdraw rolling it between your fingers for no more than 10 seconds in duration. Indicated when vomit is seen in tube or gurgling is heard.

33
Q

Which of the following age groups has a normal respiratory rate from 22-35?

A

3-5 (preschool age)

34
Q

Which unresponsive patient would benefit from an NG tube:

A

Patient has an intact gag reflex.

35
Q

Duration of flow based off of tank flow, tank size, and tank pressure:

A
36
Q

Complications of picking an improper NPA or OPA:

A

OPA’s: Too small: likely not effectively lifting the tongue, potentially causing an airway obstruction instead of maintaining a clear airway.
Too big: can cause airway obstruction, discomfort, gagging, or even damage to the throat or teeth if inserted, as it may press against the epiglottis or other sensitive tissues in the airway.

NPA’s: too big and it will enter the larynx and irritate the coughing and gag reflexes, or be inserted into the vallecula, possibly causing an airway obstruction.
Too small: unable to effectively lift the soft palate and tongue base from the pharynx, resulting in adequate airway patency and potentially not providing the necessary ventilation for the patient.

37
Q

Method for correctly installing an NPA:

A

Lube the distal end going into the nose and Insert into the right nostril bevel towards the septum. (may have to place in the left nostril if right is smaller.)

38
Q

Adventitious breath sounds, associated with pediatrics in the lower airway:

A

wheezing being the most prominent sign of lower airway obstruction in pediatric patient’s like those with asthma.

39
Q

Suctioning apneic adult patients:

A
40
Q

Best reason for choosing endotracheal intubation vs. other advanced airways:

A
41
Q

dual lumen airway, procedure, no long sounds on first ventilation, what do you do:

A

-clear the oropharynx of obstructions or secretions.
-Pre-oxygenated the patient with BVM if possible.
-Select the appropriate sized DLA and note the appropriate cuff inflation volume.
-Check the equipment by inflating and deflating cuffs to check that there are no leaks.
-Lift the chin and tongue.
-Insert the DLA into the mouth. Do not force either tube; you may cause soft tissue damage. If resistance is encountered pull back somewhat and adjust the tube, trying to follow the posterior pharyngeal wall. At proper distance of insertion as confirmed b markings on the tube, the proximal ventilating lumen will open over the laryngeal opening and the distal lumen will have entered the esophagus in most cases.
-Release your hand from the tube before inflating the cuffs.
-Inflate the cuffs, inflate distal balloon first using 10-15 ml, then inflate the proximal (pharyngeal, blue) balloon using 50-85 ml.
-Connect BVM to the ventilating lumen, then the blue lumen.
-Begin ventilation 8-10 breaths/minute.
-Assess lung ventilation by auscultation and chest rise. Confirm with ETCO2 and capnography. If assessment suggests inadvertent tracheal placement of DLA, try ventilating through the distal cuff.

42
Q

Tank size, what letter for 10 min transfer from bed:

A

D Tank

43
Q

Cannula and appropriate flow rates:

A

1-6 LPM, 24-44%

44
Q

Breakfast question: When is the glottic opening the largest?

A

During inspiration.

45
Q

Nasotracheal intubation, when do you advance the tube?

A

During inspiration.

46
Q

Pediatric intubation:

A
47
Q

Tube sizes for different patient’s:

A

7.0-8.0 for females

7.5 to 8.5 for males.
determine size based on the nostrils.

48
Q

Know about NT intubation, what equipment needs to be available to attempt?

A

Same equipment for ET intubation, minus laryngoscope and stylet. Tubes size down 1-1.5 mm compared to ET intubation, choose a tube that is slightly smaller than the nostril.

49
Q

Which of the following is true regarding pulmonary circulation?

A

part of the circulatory system that moves deoxygenated blood from the heart to the lungs to pick up oxygen, and then back to the heart. The purpose of the pulmonary circulation is to exchange blood and gases between the heart and lungs. Low pressure system that allows for improved gas exchange.

50
Q

From the list of unresponsive patients, which patient needs assisted breathing?

A
51
Q

Which of the following would be highest priority when assessing a patient complaining of difficulty breathing who also has distended neck veins?

A

Lung sounds

52
Q

Uvula

A

uvula extends from the soft palate in the posterior oral cavity; manipulation of the uvula is usually unnecessary, although the uvula is an important landmark to identify as you proceed to the posterior pharynx.
-Helps prevent food you eat from going up your nose. It can also trigger a gag reflex.

53
Q

Epiglottis

A

Leaf shaped cartilaginous structure that closes over the trachea during swallowing is located at the superior border of the glottis. When you perform ET intubation, you must visualize the epiglottis, glottis and vocal cords before inserting the ET tube.

54
Q

glottic opening

A

also known as the rima glottidis, is the narrow space between the vocal folds in the larynx.

55
Q

Vallecula

A

The space between the epiglottis and the base of the tongue, the Mac blade of the laryngoscope is placed in the vallecula.

56
Q

How to clear an airway obstruction in a 3 month old?

A

If 3 month old is not able to cry, and it appears they are not able to clear the obstruction providers will give 5 back slaps to 5 chest thrusts for responsive patient’s. If the patient goes unresponsive and not breathing then the provider will start CPR and prior to giving ventilations will check for airway obstruction to remove it.

57
Q

You are evaluating a 42 year old who is on room air and appears to be in no respiratory distress. The pulse oximetry reading is a normal tidal volume. How many tidal liters per minute of oxygen is being inspired?

A

1-2 L/Min

58
Q

What does a sign of drooling tell you about a patient with shortness of breath?

A

Airway obstruction, infection.

59
Q

Cardiac arrythmias that indicate hypoxic conditions in pediatrics?

A

Bradycardia/bradydysrhthmias

60
Q

Kussmaul respirations

A

Rapid and deep (extreme tachy and hyper)

61
Q

Eupnea respiration pattern

A

Normal

62
Q

Tachypnea breathing pattern

A

Fast

63
Q

Bradypnea breathing pattern

A

slow

64
Q

Apnea breathing pattern

A

Not breathing

65
Q

Hyperpnea breathing pattern

A

Rapid and deep

66
Q

Cheyne-stokes breathing pattern

A

Crescendo to de-crescendo with periods of apnea.

67
Q

Biot/Ataxic breathing pattern

A

Extremely irregular with periods of apnea.

68
Q

What is one of the most important concepts to remember when dealing with an adult patient with a stoma?

A

Seal the mouth and nose while ventilating through the stoma.

69
Q

which of the anatomical structures within the pulmonary system is primarily responsible for the trapped air that an asthmatic experiences?

A

Bronchioles

70
Q

Tracheal lung sounds

A

loud, high pitched, heard over the trachea.

71
Q

Vesicular lung sounds

A

Soft-low pitched, rustling sounds heard when a person breathes in (Inspiration). they are considered normal and indicate healthy lung function.

72
Q

Bronchovesicular lung sounds

A

Bronchovesicular sounds are medium-pitched and heard over the major bronchi.

73
Q

Who is going to benefit the most from an advanced airway?

A

An unresponsive infant with epiglottitis.

Airway management test review (1 decks)

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