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Flashcards in ABCDE Deck (57)
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1

MC reason that airways get obstructed

tongue and submandibular musculature

if you are not conscious that stuff lays on the back of your throat and blocks your airway

2

when would you use a jaw thrust alone to open airway

if you have not witnessed injury and it could be a C spine injury

3

review of what airway compramise looks like

•Universal choking sign

•Unconscious, deeply sedated (intoxication or medication)

•Respiratory distress, position preference (you don't want to lie down)

•Getting sleepy while working to breathe

•Changes in level of consciousness - come in talking - now difficult to arouse •

Sedated + vomiting

•Head trauma, facial trauma

•Infection somewhere along the airway

•Burns - smoke inhalation (get edema from heat/smoke inhalation)

•Face, tongue, neck edema

•Severe bleeding from nose, mouth (flooded your airway)

•Cyanosis, shock

4

inspiratory stridor indicates

narrowing at the glottis

5

what can airway trouble sound like

stridor

voice changes- hoarseness and can't get
words out

gurgling

6

when would you use a nasopharyngeal airway

for semi-conscious pts with a gagreflex

7

Nasopharyngeal Airway placement


tip of the nose to the tragus should be the fit

bevel to septum with lube
floor of the nose down until the opening is at the nostril

8

Oropharyngeal Airway is used for

Use only in unconscious, unarousable patients

NOT IN A PT WITH A GAG REFLEX--> vomit

9

Oropharyngeal Airway measurement

corner of the mouth to the angle of the jaw

10

how should you be holding laryngoscopes

with left hand

11

what should you do before intubating

make sure your balloon inflates but always insert with balloon deflated

Secures the airway by placing a tube in the airway space - secures a lumen

12

CO2 monitor should turn what color following intubation

Yellow-Yes

purple= poor

13

laryngoscope with straight blade

Miller

14

laryngoscope with curved blade

macintosh

15

indications for intubation


Can’t protect/maintain their own airway:
Alterations in level consciousness
Airway patency threatened
Edema, secretions, blood, infection,
trauma

Breathing indications
Failure to ventilate or oxygenate
Pulmonary, cardiac, systemic problem,
trauma

Preemptive
Threat to airway patency (consciousness), oxygenation, ventilation, aspiration

16

first thing to do to prop for intubation

Bag Valve Mask – BVM – essential skill

Pre-intubation ventilation – 100% O2

do this right after to before putting them on a ventilator

17

S.O.A.P M.E checklist

Suction
Oxygen
Airway equipment
Pharmacy
Monitoring Equipment

18

prep for intubation

BVM
SOAPME
Have Plan A, Plan B, Plan C
RSI - Rapid Sequence Intubation

19

RSI- What are the steps KNOW THIS

Pt is paralyzed to gain control; intubation easier, deals with full stomach - prevents aspiration
ii. The 7 P’s
1. Possibility of success
2. Prepare
3. Pre-oxygenation
4. Pre-treatment
5. Induction/Paralysis
6. Positioning/Protection
7. Pass it, prove it, post procedure tasks

20

why should you beware of paralyzing a pt

Paralyzed patient = no respiratory effort


You MUST be able to adequately ventilate the patient with bag-valve-mask

Must anticipate a successful intubation or do not paralyze

21

tubing the goose

don't pass through the chords, pass into the esophagus

will get a shift CO2 reading
happens witt big pts, looking away

No color change, low pulse ox, no breath sounds.

22

why do we get a CXR post intubation

to check depth NOT to see if it's the esophagus

23

what to do if you can't see the chords very easily

LMA-Laryngeal Mask Airway
or Bougie

i. Supraglottic airway devices
ii. Designed for blind insertion - goal is esophagus, not trachea
iii. LMA for minor surgery common, good Plan B
Nasotracheal intubation and/or fiber optic guided

All designed to minimize risk of the failed airway-

24

king tube

goes into the esophagus
inflate giant balloon and

25

Causes of Inadequate Ventilation-i. Increased airway resistance

1. Airway collapse, hyper-reactivity, edema
2. Small decreases in diameter significant
3. COPD, emphysema, asthma

26

Causes of Inadequate Ventilation-Decreased airway compliance

1. Interstitial edema and alveolar collapse
2. Pulmonary edema, effusion, shock, sepsis, aspiration, drowning, smoke inhalation, ARDS, trauma


27

Abnormalities of ventilation/perfusion

1. Acute left ventricular failure, pneumonia, pulmonary embolus, anemia, ARDS, etc…

28

Impaired wall mechanics

1. Perfused but under-ventilated alveoli
2. Pneumothorax, pneumonia, effusion, neuromuscular problems, rib fx, trauma

29

Hypoventilation/hyperventilation

1. Poisoning, toxic overdoses, intoxication
2. Acidosis
3. Endocrine disorders
4. CNS lesions

30

Inadequate Ventilation leads to

Leads to Hypoxia... and hypercarbia