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Emrg 1242 > Week 9- Suction & Trach Management > Flashcards

Week 9- Suction & Trach Management Flashcards

1
Q

Pt care equipment standards- pg 99-107

A
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2
Q

What do we use suctioning for?

A

Used to clear the airway of:
- Vomit, saliva, blood, food, foreign objects that might block airway

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3
Q

When do we suction during a call?

A
  • Can be preformed anytime during the call as required
  • Goal is to clear the airway & prevent aspiration
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4
Q

What is aspiration?

A
  • happens when food, liquid, or other material enters a person’s airway and eventually the lungs by accident.
  • Can lead to serious health issues like pneumonia and chronic lung scaring
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5
Q

All Ontario EMS Ambulance must have according to the Equipment Standards… (suction devices)

A
  • A portable suction device
  • Hand held manually operated or electric/ battery operated unit
  • Wall unit kept in Patient Compartment of Ambulance
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6
Q

What are the standards to a portable suction device?

A
  • Has to be able to be operated by one hand of the medic
  • Be compatible with industry catheters and connectors
  • Be capable of rapid disassembly and assembly, if applicable & designed to minimize incorrect assembly
  • Be designed to treat infants, children, & adults
  • Be disposable & or allowing cleaning of non disposable parts
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7
Q

Portable suction- V-vac

A
  • V-vac manual suction unit is a portable emergency unit designed for suctioning fluids and vomit from a patient’s airway
  • Once squeezed, the units provide a powerful suction range between 170-380 mmHg and 70 lpm
  • Intake valve is designed to minimize the risk of clogging problems, back-flow of suctioned matter, tube occlusion (blockage) and soft tissue injury
  • Small and lightweight; offers one-handed operation
  • Canister holds 425 mls
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8
Q

Portable Suction- Electric/ battery

A
  • Have a battery system that will allow 20 mins of continous operation
  • Be able to plug into 12 DC electrical system in vehicle
  • Reach >300 mmHg within 4 sec with everything connected tubing/ canisters
  • Include a vacuum indicator at min. 100 mmHg & provide a range from 0-550mmHg
  • Include non kinking suction tubing
  • Collection container must hold min 300 mls
  • Have a hydrophobic submicron filter 99% efficiency against bacterial/ viral organisms
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9
Q

Laerdal Compact Suction Unit

A
  • Light weight
  • 45 min of battery life
  • Used on peds/ adults
  • Hold 300 mls
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10
Q

S-Cort Suction Portable Suction

A
  • Lightweight/ 500 mmHg for adult
  • 125 mmHg for children
  • Disposable collection canister
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11
Q

Vehicle Wall Unit

A
  • Has to have a bag or canister that can hold a min of 1.1L
  • Have an on/ off switch
  • Vacuum gauge that can register 0-550 mmHg
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12
Q

Suction Tubing according to MOH standards…

A
  • Must be disposable
  • Be clear non conductive medical grade material
  • Withstand 560 mmHg suction power without collapsing
  • Be approx 6 in length & 7mm diameter
  • Have ability to connect to various suction catheters via connectors
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13
Q

What are the 3 types of suction catheters carried?

A
  • Wide bore
  • Yankauer
  • In line/ closed suction
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14
Q

What is the oral suctioning set for adults?

A

500-550 mmHg

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15
Q

What is the oral suctioning set for childs?

A

200-220 mmHg

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16
Q

What is the oral suctioning for infants?

A

80-100 mmHg

17
Q

What is the deep suctioning for trach or ETT for adult?

A

100-150 mmHg

18
Q

What is the deep suctioning for trach or ETT for child?

A

100-120 mmHg

19
Q

What is the the deep suctioning for trach or ETT for infant?

A

60-100 mmHg

20
Q

How do we suction the oropharynx?

A
  • Open pt’s airway & insert suction tip/ catheter
  • Never go past base of tongue: (could trigger gag reflex)
  • In young pt, could trigger vagal response (decrease heart rate)
  • Suction for 5-10 sec on the way out
21
Q

What is the oropharynx procedure?

A

The goal is to clear the airway
- with larger amounts of blood, vomit, secretions, roll the pt or sit them up to manually clear the airway
- set the correct pressure for the pt
- put the large bore/ cath in the mouth
- Occlude the hole in initiate suction
- Suction only on the way out of the mouth 5-10 secs max
- Pt will require oxygenation in between attempts

22
Q

What is the procedure for tracheostomy suctioning?

A
  • set correct pressure
  • Insert the cath until you meet resistance or the pt coughs
  • Suction for 10 secs on the way out
  • Ventilate/ oxygenate in between 1 min
  • Have saline for clearing catheter’s
23
Q

When suctioning through mouth what should you use?

A
  • Large bore tip or caetheter- yankauer
24
Q

When suctioning through OPA what should you use?

A
  • catheter
25
Q

When suctioning through NPA/ Nares what should you use?

A
  • catheter
26
Q

When suctioning through trach stoma what should you use?

A
  • catheter
27
Q

What are the parts of the trach?

A
  • Inner cannula
  • Neck plate- where all the info is
  • Ties or straps
  • Obturator
28
Q

What is the directive for reinsertion of tracg?

A
  • Patient with an existing trach where the inner and/ or outer cannula(s) have been removed from the airway AND
  • Respiratory distress AND
  • Inability adequately ventilate AND
  • There is no family member or caregiver who is available and knowledgeable to replace the tracheostomy cannula
29
Q

How do you reinsert a trach?

A

*Ask family member
If family member not able to, Paramedic will attempt to reinsert to a max of 2:
- A reinsertion attempt is defined as the insertion of the cannula into the tracheostomy
- A new replacement inner cannula is prefers over cleaning and reusing an existing one
- Replacing the outer cannula with a new or cleaned one is preferred
- Try twice if failed ventilate

30
Q

What are the steps for reinsertion?

A
  1. Ensure Sp02 is applied
  2. Ascertain if pt breaths via mouth & trach or just trachea
  3. Oxygenation as needed
  4. Suction as needed
  5. Assess urgency of situation
  6. Tracheostomy Tube: have available
  7. Same size & one size smaller
  8. Use obturator if available
  9. If no obturator insert new tube following natural curve of stoma
  10. Should only take 30 secs
31
Q

How do you apply oxygen to a trach?

A
  • Apply oxygen to both the patient’s face & tracheostomy site. (if there has been a laryngectomy, no connection between upper airway & trach)
  • Assess for breathing (air movement) by looking, listening, and feeling at both the mouth and trach
  • Waveform capnography should be applied if available
  • If ventilating via mouth, occlude the trach
  • If ventilation via trach place 02 mask of BVM, directly over the trach (inner cannula must be in place to attach BVM)
32
Q

What is ETC02?

A

End tidal carbon dioxide is the level of carbon dioxide that is released at the end of an exhaled breath. ETC02 levels reflect the adequacy with which C02 is carried in the blood back to the lungs and exhaled.

33
Q

What is normal ETC02?

A

35-45 mmHg

Emrg 1242 (10 decks)

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