Supraglottic airways Flashcards
Ventilation-
Oxygenation-
-act of inhaling and exhaling
-addition of oxygen to the bloodstream
What happens if there’s inadequate ventilation
Respiratory acidosis
-lungs can’t efficiently get rid of CO2
How do we measure ventilation
-look at respiratory rate and effort
-end-tidal CO2- volume of CO2 expired
Stepwise approach for airway management
-manual manoeuvres
-OPA/NPA
-i-gel/ supraglottic airway device
-endotracheal intubation (ETI)
Steps for i-gel ventilation
-position, HTCL, place OPA, connect airway circuit
-ventilate 12 per min
-select correct size of i-gel
-lubricate cuff of i-gel
-open mouth
-place tip of i-gel against hard palate
-glide against roof of mouth until resistance
-reconnect circuit and ventilate (less than 30sec between OPA and i-gel)
-confirm with ETCO2 and auscultation
-secure in place
Why must filter go in front of end tidal CO2 monitor
-vomit can get stuck in the tube meaning no readings will show
Benefits of I-gel
-better seal because we’re sealing around the supraglottic structures
-less likely to inflate stomach causing regurgitation
-avoid hyperventilation
-frees up hands
How many attempts to insert I-gel
no more than 3 attempts
What is ETCO2, normal value and how measured
-measure of expired CO2
Normal value= 4.0-5.7 kPa
-capnometry= gives us a number
-capnography= graph/waveform
Normal waveform looks like
x axis= time y axis= CO2 expired
Normal waveform= shape of a top hat
-baseline= 0mmHg
-upon expiration rise on graph= expiratory upstroke
-then alveolar plateau
-end of plateau= where ETCO2 measured
-inspiratory down stroke
Why can ETCO2 be low
-metabolism due to cardiac arrest
-circulatory- eg. if stabbed may loose blood so not able to get CO2 back to lungs effectively, or low BP
-respiratory- breathing too quick
Ventilation strategies
-if low or high
-if low ETCO2 = slow ventilation
-if high supply= increase ventilation rate
