Week 2 airway Flashcards
Vent rates=
adult = 5-6 secs (10-12 per min)
infant/child w/ pulse 3-5 secs (12-20 per min)
4 methods of ventilation:
mouth to pocket mask, 2 person BVM, demand valve/FROPVD, 1 person BVM
Sniffing position=
pillow under head ear aligned with sternum (called sniffing bc/ way head recoils when you shift)
Ramped position=
for obese PTs, <LOTS>prepare a proper ramp (head and shoulder support) before transferring them to the ambulance.</LOTS>
Compressed gaseous oxygen is stored in an aluminum or steel tank in 400-liter (D), 660-liter (E), and 3,450-liter (M) volumes.
D tank life = (Tank pressure in psi X 0.16) / LPM
E tank life = (tank pressure in psi X 0.28) / LPM
M tank life = (tank pressure in psi X 1.56) / LPM
Therapy regulator=
used for delivering oxy to PTs→ default PSI 50
High pressure regulator=
used to transfer oxy at high pressures from tank to tank
Rules of 3s in optimal ventilation:
3 practitioners (1 on mask, 1 on bag, 1 one for ELM)
3 inches (elevate PT head 3 inches for sniffing position)
3 fingers ( 3 fingers on larynx to perform ELM)
3 PEEP ( or up to 15cm/H2O PEEP as need to improve oxy saturations)
Extraglottic Airway devices=
inserted blindly into esophagus
(ETC) esophageal tracheal combitube=
may enter trachea or esophagus
Laryngeal Mask airway (LMA)=
LMA-Supreme=
LMA-Fastrach=
1st laryngeal airway
Updated LMA
1st intubating airway designed to facilitate blind endotracheal intubation
Retroglottic airway devices=
king LT
King LT-D
King LTS-D
Pharyngo- tracheal lumen (PTL)=
King LT airway=
large silicone cuff; disperses pressure over large mucosal surface area
King LT-D Airway=
disposable single-lumen latex-free retro glottic airway
King LTS-D airway=
disposable single-lumen latex free retro glottic airway that also has a chanel for the placement of a gastric tube
Supraglottic Airway devices=
(above glottic opening)
laryngopharyngeal tube
I-Gel
laryngopharyngeal tube
(S.A.L.T)→ simple mechanical airway adjunct; blind endotracheal tube inducer
I-Gel Airway=
single use, mirrors natural anatomy, no inflatable cuff
Endotracheal Intubation=
inserting endotracheal tube into trachea, usually w/ direct visualization of vocal cords via direct laryngoscopy (optimal aspiration protection & ventilation
Laryngoscope Blades=
Curved bladed “Mac” → c curved Straight blades “Miller” → to Ls straight
Straight blades
Robert Shaw Fibre Optic Blades= designed for neonatal & infant use, available size 0 &1
Seward Fibre Optic Blades= designed for infant & PEDI use, available size 1 & 2
Wisconsin Fibre Optic Blades= designed for neonatal & infant use, available size 0,1,2,3,4
Avulse=
Dislodge
Eustachian (auditory) tubes=
ear tubes that connect to nasal cavity to help with balance of pressure on the tympanic membrane
Pharynx=
allows air to flow into & out of the respiratory tract & food/liquids to pass into the digestive system
divided into 3 regions: nasopharynx, oropharynx, & hypopharynx
Bronchioles=
are encircled with smooth muscle that contains -(B2) adrenergic receptors. When stimulated, these -(B2) receptors relax the bronchial smooth muscle, thus increasing the airway’s diameter
Alveoli=
membrane that is only 1 / 2 cell layers thick & is surrounded by a network of capillaries and responsible for gas exchange (02 & CO2)
Sufarctant=
Alveoli chemical lube
atelectasis=
alveolar collapse–> can be from not enough inflation or surfactant
Partial pluera=
Visceral pluera=
no nerve ending
Many nerve endings
Partial pressure=
pressure exerted by a single gas in a mixture of gases.
Alveolar partial pressures are abbreviated=
PA (PAO2 and PACO2)
arterial partial pressures are abbreviated=
Pa (PaO2 and PaCO2)
Oxyhemoglobin dissociation curve=
Hemoglobin’s affinity for oxygen (how readily it binds to oxygen) depends on factors: temp/, pH, and PaO2. As the PaO2 increases, so does hemoglobin’s affinity for oxygen.
oxygen saturation formula=
O2 content / O2 capacity x 100%
oxygen content of the arterial blood (CaO2) formula=
CaO2= (SaO2 X Hgb X 1.34) + (0.003 X PaO2)
Hering-Breuer reflex=
prevents over expansion of lungs from inhalation>
During inspiration, lungs become distended, activating stretch receptors.
chemoreceptors=
in the carotid bodies and in the arch of the aorta. These chemoreceptors are stimulated by decreased PaO2, increased PaCO2, and decreased pH
Inspiratory reserve volume (IRV)=
maximum amount of air that can be inhaled after a normal inspiration.
Expiratory reserve volume (ERV)=
maximum amount of air that can be exhaled after a normal expiration.
Residual Volume (RV)=
amount of air remaining in the lungs at the end of maximal expiration
Functional residual capacity (FRC)=
volume of gas that remains in the lungs at the end of normal expiration
pulsus paradoxus=
BP drop more than 10→ can indicate severe obstructive lung disease.
ETCO2=
Measurement of the CO2 concentration at the end of expiration (maximum CO2).
PETCO2=
Partial pressure of end-tidal CO2 in a mixed gas solution
PaCO2=
Partial pressure of CO2 in the arterial blood
End-tidal gradient=
Difference between partial pressure of arterial CO2(PaCO2) and the end-tidal CO2(ETCO2).
Formula: PaCO2 - ETCO2 = End - Formula gradient
Oxygenation 3 needs=
intact airway, adequate vent & respiration
CO2 waste=
lot heat, lot H2o, lil/ Co2
Katabolism=
uses fat vs glucose for energy (uses 4 ATP vs. 1)
Most prevalent intracellular Ion=
Most prevalent extracellular ion=
Potassium
Sodium
Hyperkalemic leads to=
messed up cell membranes leaking out of cells
Crethimoid=
thinnest bone in skull (basilar skull frac)
Kiesselbach area(little area)=
where 4 different arteries connect together→ super vascular
Mucus F. =
absorb energy, balance, heat dental roots
Pogo=
%/scale of glottic opening
what to look for during Endotracheal intubation=
Corniculate, cuneiform, & artynoid cartilage while intubating
Pre-Botzinger complex=
“Sa node” of the RR
VRG ventral respiratory group=
transmits signals via the phrenic nerve & intercostal nerves
DRG dorsal respiratory group=
keeps in check w/ VRG
Pontine respiratory group=
smooths out transition of inhalation & exhalation
BOHR effect=
hemoglobin right shift and release oxygen
HALDER effect=
hemoglobin left shift picks up oxygen and releases wastes
Glabella chin plate=
unibrow space aligned with chin & ear lobe aligned with sternal notch & neck wide open (NREMT-P pillow under shoulders)
Oxygen molecules w/o a job become=
free radical hurting brain & cardio molecules
DISS Fitting diameter index setting system?
Uses 2:5 pin sizing system
inhale : exhale rate=
1:2 secs
ET Tube sizes:
Adults 6.0-9.0
Pedi tubes(2.5-5.5)
Merphy’s eye=
at lateral distal eye for open end vent
