Airway Management Therapuetics and diagnositcs
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| show | Insert and maintain artificial airways.
Proficient in airway clearance.
Assist physcicians in performing procedures related to airway management.
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| show | Pharyngeal airways
Tracheal airways
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| What are the two types of pharyngeal airways? | show 🗑
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| What are the two types of tracheal airways? | show 🗑
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| show | between the lips and teeth
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| The Oropharyngeal airway is made of | show 🗑
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| What are the components of an oropharyngeal airway? | show 🗑
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| What are the indications of an OPA? | show 🗑
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| show | A conscious patient due to gag reflex
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| show | laryngospasm/cough
vomiting/aspiration (do not tape in place)
Airway obstruction
lip or tongue damage
dental damage.
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| You should never place an OPA in the presense of a | show 🗑
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| When you place an OPA you can | show 🗑
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| The OPA is sized from | show 🗑
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| What are the most common OPA sizes for the adult airway | show 🗑
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| What are the two types of OPA | show 🗑
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| The Berman OPA has a | show 🗑
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| show | Center air channel
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| The OPA rests at | show 🗑
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| show | facilitate bag mask ventilation
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| show | OPA
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| show | nasal trumpet
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| show | into the nose and rests behind the tongue just above the epiglottis
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| The NPA is made of | show 🗑
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| All NPA's have a | show 🗑
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| The bevel on the NPA assists with | show 🗑
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| show | 1. increase effectiveness of bag/mask ventillation
2. aid with suctioning and bronchoscopy.
3. management of facial anomolies
4. eliminates risk of oral damage.
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| What are the complications of an NPA | show 🗑
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| The NPA is better tolerated by a | show 🗑
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| show | the adult population
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| show | seizure patients and is good to assist in NTS
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| show | you should be mindful if the patient is on anticoagulant therapy
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| show | flange
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| How do you size an NPA? | show 🗑
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| The NPA is sized in French and normal is | show 🗑
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| The nasopharyngeal airway is placed like so | show 🗑
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| show | mouth or nose thru the glottis and into the trachea.
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| show | 1. To bypass an upper airway obstruction.
2. To protect the airway from aspiration.
3. To apply positive pressure ventilation.
4. To aid clearance of secretions
5. To deliver high oxygen concentrations.
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| You can instill drugs down an ET tube. | show 🗑
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| show | Narcan
Atropine
Valium/Versed
Epinephrine
Lidocaine
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| What are the advantages of oral intubation? | show 🗑
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| What are the disadvantages of oral intubation? | show 🗑
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| show | fast
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| The hazards of oral intubation include | show 🗑
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| The ET Tube sized in | show 🗑
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| The centimeter markings indicate the | show 🗑
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| show | ridgitity
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| show | 8 mm
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| An adult female | show 🗑
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| You should aim not to go below | show 🗑
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| During nasal intubation the tube is | show 🗑
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| The advantages of nasal intubation | show 🗑
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| show | nasal/paranasal complications
more difficult to perform
Spontaneous breathing is required for procedure (for blind)
Smaller tube is necessary
difficulty suctioning
increased airflow resistance
increased WOB
difficulty passing bronchoscope
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| show | Mcintosh
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| show | 3 or 4 for adults
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| The Mcintosh is not typically used in | show 🗑
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| show | vellecula space and indirectly picks up the epiglttis
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| show | the straight blade
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| The miller should directly lift the | show 🗑
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| show | neonates
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| The average adult size is the | show 🗑
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| Difficult intubations are reported in | show 🗑
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| show | 1% of intubations
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| show | supraglotic structures, laryngeal inlet, vocal cords
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| show | epiglottis, laryngeal inlet, posterior aryepiglottic folds
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| show | epiglottis only
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| show | epiglottis not visable
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| The Lemon Law | show 🗑
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| Obesity | show 🗑
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| Facial hair | show 🗑
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| show | Hide airway, obscure tube passage
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| Jagged teeth | show 🗑
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| show | mouth open (3 fingers)
Mentum to hyoid (3 fingers)
Floor of mouth to thyroid cartilage (2 fingers)
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| show | allows for insertion of tube/laryngoscope
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| show | predicts ability to lift tongue into mandible
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| show | if high larynx, airway tucked underbase of tongue hard to visualize
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| show | with patient seated extend neck, open mouth, stick out tonge.
Visualize base of tonge, facial pillars, uvula, pharynx
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| show | Angioedema
Hematoma
Dentures (remove dentures)
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| Neck mobility? | show 🗑
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| The neck mobility | show 🗑
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| Endotracheal Tube is semirigid and made out of | show 🗑
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| Endrol Tube | show 🗑
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| show | 15 mm adaptor
Pilot balloon
spring loaded valve
murpheys eye
radiopaque strip
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| show | shows cuff integrity
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| show | allows for collateral ventillation
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| The spring loaded valve | show 🗑
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| show | Carlens tube
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| The Double lumen tube is more difficult to insert and usually uses a | show 🗑
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| show | longer suction catheter
causes increased airway resistance
used for unilateral lung disease
used for thoracic surger
has a double lumen cuff
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| The EVAC tube | show 🗑
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| The EVAC tube | show 🗑
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| What are the supplies for oral intubation? | show 🗑
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| show | always have extra batteries and bulbs
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| show | adds rigidity to the tube
also called Bougie
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| show | Cricoid presssure for the anterior vocal cords
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| Where should the cuff on the ETT rest? | show 🗑
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| show | 2-4 cm above the carina
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| show | 21-23 cm at the lip
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| How long should you hyperinflate and hyperoxygenate for the oral intubation procedure? | show 🗑
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| show | Magill forceps for direct visualization only.
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| show | Direct- supine
blind (fowlers position)
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| During a blind nasal intubation procedure you will hear a harsh cough and then | show 🗑
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| How do you confirm placement of the airway? | show 🗑
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| show | the most accurate way to confirm placement
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| show | position in the airway
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| show | Direct airway visualization
minimal neck movement
may overcome difficult view
useful in disrupted airway
durable, sturdy instruments
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| show | Expensive
expertise requires practice
visual field easily impaired by blood and secretions.
not readily available
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| show | minimal neck movement
useful adjunct to laryngoscopy
portable and inexpensive
usable in bloody airway
provides definitive airway
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| show | blind technique
may damage airway
usually requires darkened room
expertise requires practice
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| show | 7 days
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| What are the indications of a tracheotomy? | show 🗑
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| A tracheotomy is performed by | show 🗑
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| What are the advantages of the tracheotomy? | show 🗑
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| show | Surgical procedure
hemorrhage
SQ emphysema
pneumothorax
pneumomediastinum
permanent scar
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| Where is the tracheotomy usually done? | show 🗑
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| What are the two types of tracheotomy methods? | show 🗑
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| show | has less complications
minimal scaring
ETT not removed until placement
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| show | PVC
Rigid
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| show | American society for testing and materials
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| show | 8 & 6
Even sizes
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| The trache is no more than 2/3 to 3/4 | show 🗑
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| What are the parts of the tracheostomy tube? | show 🗑
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| show | when there is no major concern about aspiration or being able to protect airway
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| show | facilitate speech
be cuffed or uncuffed
inner cannula must also be fenestrated
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| The metal tracheostomy tube is called the | show 🗑
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| show | long term use
sleep apnea
obesity
can clip on 15 mm adaptor/cuff
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| What are the complications of intubation during the procedure? | show 🗑
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| What are the complications of intubation while tube is in place? | show 🗑
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| What are the complications of intubation post extubation? | show 🗑
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| What is the number one complication post extubation? | show 🗑
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| Complications may sometimes occur | show 🗑
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| Airway trauma can occur as | show 🗑
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| show | glottis and vocal cord swelling
laryngeal and vocal cord ulcerations
vocal cord polyps and granulomas
vocal cord paralysis
laryngeal stenosis
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| Tracheal lesions | show 🗑
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| show | a rapid sequence intubation
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| show | Sedative (Versed, Valium, Propofol)
Paralytic (succynlcholine)
lidocaine (anti arythmic
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| The RSI is given to | show 🗑
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| show | cuff is inflated
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| show | cuff
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| The methelyne blue test checks for | show 🗑
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| show | common trache brand name
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| The tracheal button | show 🗑
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| show | Pulls air out to deflate, reinflates on its own
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| show | 4-5 cc h20 into cuf
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| What are the benefits of a bivona cuff? | show 🗑
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| The Bivona may not be the best choice in the case of | show 🗑
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| Overweight patients can benefit from the | show 🗑
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| What are some airway damage indicators? | show 🗑
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| Checking cuff pressures must be done during | show 🗑
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| Minimal Occluding Volume (MOV) | show 🗑
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| MOV | show 🗑
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| show | 1. Take out air until you hear leak.
2. Put air back till you don't hear it.
3. Pull out till you hear a slight leak at peak pressure of every breath.
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| The most common suction catheter size | show 🗑
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| show | (Inside Diameter *3.14)/2
Do not round up
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| How to determine suction catheter size Method 2 | show 🗑
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| How do you prevent airway trauma? | show 🗑
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| Airway maintenance | show 🗑
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| What do you need to secure ETT? | show 🗑
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| What do you need to secure tracheostomy? | show 🗑
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| show | 2-4 cm above the carina.
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| show | Size and cm markings
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| show | 2-13 percent.
#1 contributing factor: lack of secure placement
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| The Ideal method for securing ETT | show 🗑
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| ETT securing tips. | show 🗑
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| What are the 2 classifcation of cuffs? | show 🗑
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| When maintaining cuff pressure, it is important to | show 🗑
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| show | 20-25 mm HG
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| show | less than 20 mm Hg or less than 25 cmH20
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| show | minimal leak technique or minimal occluding volume technique to inflate the cuff
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| What are alternative cuffs used to prevent overinflation? | show 🗑
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| The Lanze cuff has | show 🗑
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| How can you tell if patient has retention of secretions? | show 🗑
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| What are the types of suctioning methods? | show 🗑
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| show | whistle tip (most common)
coude catheter (angled end)
red robin (less rigid)
Ring tip (prevents damage)
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| show | hypoxemia
bradycardia
atelectasis
airway trauma
bronchospasm
contamination of lower resp. tract
arrhythmias
increased icp (coughing)
preferential suctioning of right pronchus.
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| A leukins trap is used | show 🗑
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| show | 100% at body temp; 44 mg/L
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| Heat humidification systems to | show 🗑
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| Provide at least | show 🗑
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| Decreased humidity will mean | show 🗑
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| show | decreased ciliary function
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| What are some common types of humidification systems? | show 🗑
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| What are reasons for increased infection risk? | show 🗑
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| show | consistently wash hands between patients.
Prevent retained secretions
use sterile technique when suctioning
keep airways clear
decrease pharyngeal aspiration
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| What are some ways of communicating using alternative methods? | show 🗑
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| Tracheostomy patients may benefit from | show 🗑
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| show | tube obstruction
cuff leak
accidental extubation
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| What are examples of tube obstruction? | show 🗑
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| What are clinical signs of an airway emergency? | show 🗑
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| In preparation for airway emergency | show 🗑
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| show | reposition the head/neck
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| show | use an OPA or bite block
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| show | deflate/reinflate
try to pass suction catheter to determine if cuff is herniated
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| show | reposition the airway and head/neck
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| In the event of a mucus plug | show 🗑
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| show | stick ett down the trache.
Put gauze over stoma and bag
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| show | extubation
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| Extubation is the | show 🗑
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| What are indications of extubation | show 🗑
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| show | 5-15% of cases
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| show | intubate
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| show | make sure the underlying cause is resolved.
Check hemodynamics, ABG/Lab values, wean drugs
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| show | the removal of the tracheostomy tube
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| Decannulation requires the use of | show 🗑
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| show | A tracheal button
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| show | swallowing ability
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| show | blind
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| The LMA is for | show 🗑
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| show | larynx
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| show | less complicated than ETT and requires ventilating pressures of less than 20 cm H20 for a good seal
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| The main sizes for adult LMA's are | show 🗑
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| The Esophageal obturator (EOA) | show 🗑
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| The EOA | show 🗑
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| show | is used in place of an EOA
insert tube, inflate both cuffs
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| show | esophageal placement
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| show | thorough assessment to determine placement.
Must ventilate through appropriate lumen
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| The ETT exchanger is inserted through the | show 🗑
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| Oxygen can be | show 🗑
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| The Esophageal-Tracheal Combitube is inflated as such | show 🗑
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| For impossible intubation, the ett is thread over a guidewire in | show 🗑
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| Regrograde intubation | show 🗑
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| show | definitive airway
minimal neck movement
does not require full mouth open
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| Disadvantages of retrograde | show 🗑
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| Average NTS catheter size | show 🗑
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| What are supplies for tracheostomy care? | show 🗑
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| show | suction patient
insert clean or new inner cannula
clean stoma site
replace dressings and ties
auscultate chest
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| To reduce inflammation post extubation you can give | show 🗑
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| show | 40% before extubation
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| To check for swelling prior to extubation you can | show 🗑
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| show | scar tissue
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| show | softening
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| stenosis | show 🗑
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| tracheoinnominate fistula is | show 🗑
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