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prehospital care theory > week 6 - airway > Flashcards

week 6 - airway Flashcards

1
Q

order in which you check a patient

A
  1. airway
  2. breathing
  3. circulation
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2
Q

3 things checked for when assessing an airway

A
  1. patent
  2. protected
  3. functional
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3
Q

patency

A

ability of a person to breath, with air flow passing to and from the respiratory system through the oral and nasal passages

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4
Q

3 possible causes of failure of patency

A
  1. trauma - facial fracture, tracheal laceration
  2. allergy - angioedema of the tongue or pharynx
  3. disease process - prevents or impedes a clear trajectory for air to travel
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5
Q

nasal cavity

A

functions to humidify, warm, filter and act as a conduit for inspired air

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6
Q

paranasal sinuses

A

hollow spaces filled with air, located around the nose inside the skull

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7
Q

nasopharynx

A

most superior (upper) portion of the pharynx bounded superiorly by the skull base and interiorly by the soft palate. connects the nasal cavity to the oropharynx

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8
Q

hard palate

A

separates the oral cavity from the nasal cavity and from the floor of the nasal cavity and toor of the oral cavity

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9
Q

soft palate

A

the soft tissue constitutes the back of the roof of the mouth

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10
Q

oropharynx

A

middle part of the pharynx (throat) and is behind the mouth

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11
Q

tonsil

A

lymph nodes in the back of the mouth and top of the throat that help filter out bacteria and other germs to prevent infection in the body

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12
Q

tongue

A

muscular organ, and is formed by complex inartistic and extrinsic muscles

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13
Q

intrinsic muscles

A

change in the shape of the tongue

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14
Q

extrinsic muscles

A

in charge of moving the tongue in different directions

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15
Q

laropharynx

A

crucial connection point through which food, water and air pass

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16
Q

vocal cords

A

2 bands of smooth muscle tissue found in the larynx (voice box)

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16
Q

epiglottis

A

small, leaf-shaped sheet of elastic cartilage that protects your larynx (voice box) and helps you swallow

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17
Q

esophagus

A

tubular, elongated organ of the digestive system which connects the pharynx (throat) to the stomach and is the organ that food travels through to reach the stomach for further digestion

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18
Q

trachea

A

long, U shaped tube that connects your larynx (voice box) to your lungs

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19
Q

nares

A

nostrils

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20
Q

mandible

A

largest bone in the human skull (lower jaw)

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21
Q

thyroid cartilage

A

the largest cartilage of the larynx (voice box) and is composed of hyaline cartilage

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21
Q

hyoid bone

A

small U-shaped (horseshoe-shaped) bone that is situated in the midline of the neck anteriorly at the base of the mandible and posteriorly at the 4th cervical vertebrae

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22
Q

cricoid cartilage

A

serves to maintain airway patency and functions in the opening and closing of the vocal cords for sound protection

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23
Q

thyroid gland

A

produced hormones that regulate the body’s metabolic rate, growth and development and play a role in controlling the heart, muscle and digestive functions, brain development etc

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24
Q

5 components of the upper airways

A
  1. nose
  2. mouth
  3. sinuses
  4. pharynx (upper section of the throat)
  5. larynx (voice box).
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25
Q

5 components of the lower airways

A
  1. trachea
  2. lungs
  3. bronchi
  4. bronchioles
  5. alveoli.
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26
Q

stertorous respirations

A

snoring, vibrations of air sneaking through
- happens when the tongue drops down and blocks the airway
- airway is not protected or patent

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27
Q

what is the #1 thing well see in an unconscious patient

A

in the unconscious patient, the most common site of airway obstruction is at the level of the pharynx (throat) and the obstruction has usually been attributed to posterior displacement of the tongue caused by reduced muscle tone (tongue falls back blocking airway)

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28
Q

airway obstruction

A

a blockage in any part of the airway

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29
Q

2 types of obstruction

A
  1. partial
  2. complete/total
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30
Q

where can a partial or complete airway obstruction occur

A

any level from the nose to the trachea

31
Q

causations of airway obstruction

A
  1. vomit
  2. blood
  3. swelling of the airway
  4. foreign body
  5. laryngeal spasm
32
Q

choking

A

foreign body causing airway obstruction

33
Q

partial choking

A
  • can still breathe
  • may be coughing
  • may be talking
  • watch and encourage them to cough
34
Q

complete choking

A
  • hands on the neck
  • no sounds or noises
  • complete blockage of the airway
  • need help immediately
35
Q

airway compromise

A

occurs whenever a traumatic or medical event causes a disruption in the natural and unimpeded flow of air through the airway structures

36
Q

what becomes the top priority when the airway is compromised

A

airway management because the top priority in patient care

37
Q

level of responsiveness

A

A - alert
V - verbal
P - pain stimulus
U - unresponsive

38
Q

7 medical causations of airway compromise

A
  1. allergy (anaphylaxis)
  2. COPD
  3. vomiting
  4. asthma (respiratory infection)
  5. loss of consciousness
  6. seizure
  7. overdose (intoxication)
39
Q

5 trauma causations of airway compromise

A
  1. hanging
  2. direct trauma
  3. head injury
  4. tongue bite
  5. burns
39
Q

anything plus LOC (unresponsive) results in

A

airway compromise

40
Q

cyanosis

A

lack of oxygen

41
Q

what causes a seizure

A

electrical impulses all signaling and firing at once

42
Q

airway swelling

A

swelling of the upper airways can cause life-threatening injuries because of the limited ability to move air

42
Q

2 main things to do when treating a patient with a seizure

A
  1. keep their airway clear (make sure nothing is obstructing the airway)
  2. keep the patients safety a priority
43
Q

what do you look for when assessing airway

A
  1. positioning
  2. fluids and secretions
  3. swelling
  4. injury
  5. adventitious sounds
43
Q

what are we always assessing the airway for

A

patency

44
Q

4 things looked for when assessing the airway for fluids and secretions

A
  1. vomit
  2. blood
  3. saliva
  4. mucus
45
Q

what are you visualizing in a less responsive patient

A

oropharynx

46
Q

turbulent airflow produces what type of sounds

A
  1. snoring/ sturtor
  2. stridor
47
Q

what is turbulent airflow caused by

A
  1. poor position
  2. loss of motor tone (tongue)
  3. presence of secretions
  4. airway edema
48
Q

assessing for airway for a responsive vs unresponsive patient

A

responsive
- observe for airway patency through speech (talking to them shows airway patency)
- visualize the head/ neck and inside of the mouth

unresponsive
- visualize the head and neck for positioning
- open the mouth and visualize the oropharynx for fluids and secretions and foreign objects
- listen for adventitious sounds

49
Q

what is the first step in airway management

A

manual positioning

50
Q

what is something to consider when checking for airway management in a patient

A

spinal injury (spinal immobilizations)

51
Q

4 manual positioning techniques

A
  1. jaw thrust
  2. head tilt, chin lift
  3. sniffing posiiton
  4. ear to sternal notch (E2SN)
52
Q

when to use jaw thrust

A
  • risk of cervical spine injury
  • can be used effectively on any patient
53
Q

what does performing a jaw thrust do

A
  • brings the mandible forward and relieves obstruction by the soft palate and epiglottis and lifts the tongue off the oropharynx
54
Q

sniffing position

A
  • this involves neck flexion (elevation of the head)
55
Q

how is a sniffing position achieved

A
  • by placing a pillow/blanket under the head and then extending the head at the atlas and occipital bone
56
Q

which is the most preferred airway management position

A

ear to sternal notch

56
Q

4 indications to use the ear to sternal notch technique

A
  1. decrease or unresponsive patient without suspected spinal injury
    - position the blankets and pillows under the top of the shoulders and under the back of the head
  2. face plane is parallel with ceiling
  3. ears should be level with the chest (sternal notch)
57
Q

suctioning

A
  • the presence of fluid or secretions like blood, vomit etc can result in aspiration and is life threatening
58
Q

2 types of suctioning devices used

A
  1. VVAC (manual)
  2. Automated
59
Q

VVAC suction technique

A
  1. for liquids use the “straw” attachment
  2. if there is thick or chunky matter do not use any attachment
60
Q

how far do you suction

A

as far as you can see in the oropharynx

61
Q

which suction is mandated by the MOH

A

VVAC

61
Q

how long do you suction

A

10-15 seconds then reassess

62
Q

for the portable (automated) suction at what suction pressure do you use

A

between 300-550 mmHg (depends on the rate of fluids produced or thickness)

63
Q

oropharyngeal airways (OPA)

A
  • a curved plastic device designed to follow the curvature of the palate
  • once you size correctly place until you hit the hard palate then rotate it to insert
63
Q

2 types of suction catheters for portable suction

A
  1. wide bore
  2. yankeur
64
Q

when to use OPA

A

designed to be used in unconscious patients with no gag reflex that require airway support

65
Q

indications and uses of OPA

A

indications
- unconscious
- no gag reflex

uses
- used to lift the tongue off the airway (create patency)

66
Q

techniques for inserting a OPA

A
  1. hard palate
  2. soft palate
  3. rotate 180 degrees
  4. rest at teeth
67
Q

Nasopharyngeal airway (NPA)

A
  • designed to relieve soft tissue upper airway obstruction in a patient requiring airway support
  • bevel to septum
68
Q

indications to use a NPA

A
  • decreased level of responsiveness
  • requires airway support, but has intact gag reflex
  • insert right nostril first
69
Q

where do you measure for the sizing of a NPA

A
  • measure from the tip of the nose to the trigs of the ear
70
Q

contradictions of using a NPA

A
  • basil skull fractures (bruising around the ey and ears or fluid)
  • fluid leakage from the nose or ears (blood)
  • should not be used on patients with significant facial and head trauma
71
Q

3 ways to airway management

A
  1. positioning (4 techniques)
  2. suctioning (if needed)
  3. adjuncts (OPA/NPA)

prehospital care theory (5 decks)

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