Ventilation/Airway Flashcards
Define dead space
The conducting zone
Needs to have 2-way flow (circuit tubing is 1-way so NOT dead space, only whatever’s after the Y to the pt)
1-2 mL/Kg IBW
ETT subtracts 40-50% of the dead space
What is permissive hypercapnia?
Decreased pressures to protect lungs (decreased Vt and pressure)
pH needs to stay within 7.2 - 7.25
Max EtCO2 of 45-80 mmHg
What is the venous PCO2 compared to PaCO2?
What is the EtCO2 compared to PaCO2?
Venous PCO2 is 5-8mmHg higher than PaCO2
EtCO2 is 3-5mmHg less than PaCO2
What is the max PIP for BVM ventilations?
15-20mmHg max, otherwise the pressure > the strength of the cardiac sphincter and air will go gastric
Measured via the manometer on the BVM
What does the lung/O2 button do on the T1?
Increases O2 to 100% (125% in neonate mode) for 2 minutes. Can be cancelled by pressing the button again or adjusting FiO2 setting.
RODS is used to assess for what kind of airway - and what does it stand for
SGA/LMA
Restricted mouth
Obstruction
Disrupted/distorted
Stiff lungs/c-spine
What does LEMON stand for and when would you use it?
To assess for a difficult intubation
Look
Evaluate (3/3/2)
Mallampati score
Obstruction/obesity
Neck mobility
How do you assess LEMON based on a score (1-10) and a number > ___ is a predictive of a difficult intubation
Look - facial trauma (1pt), large teeth (1pt), beard (1pt), large tongue (1pt)
Evaluate - 3 fingers for mouth opening (0), <3 fingers (1)
hyomental distance 3 fingers or more (0), <3 (1)
thyromental distance 2 fingers or more (0), <2 (1)
Mallampati - score of 1,2 (0), score of 3,4 (1)
Obstruction - is there obstruction (1), no obstruction (0)
Neck - collar (1), no collar (0)
A score of >3 or more (out of 10) is predictive of a difficult intubation
What is a modified LEMON score and a score of _____ or more is predictive of a difficult airway
LEON score of 3 or more (out of 9) is predictive of a difficult intubation
Same scoring as LEMON but remove Mallampati scoring
SHORT is used to assess for what airway intervention and what does it stand for
SHORT for difficult cricothyrotomy
Surgery/other airway obstruction
Hematoma (including infection/abscess)
Obesity
Radiation distortion (other deformities)
Tumor
What are the 6 reasons to intubate? (ABCDEF)
- *A**irway (burns, edema, tumour, trauma, etc)
- *B**reathing (failure of oxygenation or ventilation)
- *C**irculation
- *D**isability (CNS depression or catastrophe)
- *E**xpected course (pt decline, transferring to specialty)
- *F**eral (need aggressive sedation for safety of pt +/- medic)
How do you re/preoxygenate your pt?
NC at 15 lpm
NRB at 15 lpm
What does SALAD stand for and what are the 6 steps?
Suction Assisted Laryngoscopy Airway Decontamination
- Suction oropharynx w/ rigid cath
- Use cath to move tongue during laryngoscopy
- Park cath in esophagus (if vomiting)
- New cath in L side of pts mouth
- Intubate with bougie
- Finish by suctioning around trachea after cuff inflation
What are the four steps of airway positioning?
- Ears to nose (E2N)
- Head of bed/head of pt up (HOB/HOP up)
- 360 degree access w/ pt at belly/belt height
- Team, equipment, assistants briefed and ready
What are the 3 situations included in the phrase “death by laryngoscope”?
Hypoxia
Acidosis (esp DKA)
Hypotension
