CO2 levels high, symptomatic Hypercapnia is an indication for intubation. COPD, emphysema, asthma

Indications for Intubation

Sx hypercapnia, sx hypoxemia, airway protection against aspiration: comatose, neuro insult, overdose; general anesthesia, need to control and remove secretions --pulmonary toilet

Contraindications (relative) of Intubation

Awake patient, airway can be managed less invasively, severe airway trauma and obstruction --cricothyrotomy indicated, Cervical Spine injury. Don't forget RA

Look externally, Evaluate the 3-3-2 rule, Mallampati score, Obstruction?, Neck Mobility

Class IV Mallampati Grade

Can't see airway. Class I, best visualization

Cormack-Lehane grades what?

View of Glottic Opening. Grade 1&2 have low failure rates. Grade 3&4 have high failure rates

Recommended for 5 minutes in controlled settings

Placement of patient for intubation

place patient in "sniffing" position -- align axis. Hyperextended neck.

CO2 is acidic and should turn litmus paper (?)

Purple. Yellow means good ventilation

Tip of ETT Should be above

the Carina, don't want to be in the right mainstem.

Prolonged intubation attempts

can have hypotension, arrhythmias, vocal cord avulsion

Nasotracheal intubation may be useful in some situations:

Possibly spinal injury, clenched teeth, fractured jaw, oral surgery, airway swelling, obesity, arthritic preventing sniffing position

Contraindications to Nasotracheal tube

apneic patient, severe midface fractures or suspicision of basilar skull fx, coagulopathy (b/c nose if very vascular)

How should insertion of Nasotracheal tube be timed?

Time brething and advance at beginning of inspiration. Expect patient to cough with placement

BAAM device can be used when?

In placement of Nasotracheal tube

Pediatric Airway characteristics

smaller, flexible, tongue is proportionately larger, epiglottis is floppy and round, glottic opening higher and anterior, vocal cords slant upward and closer to base of tongue, narrowest part is cricoid cartilage

Help

Options

focusNode

Didn't know it?
click below

Knew it?
click below

Don't Know

Remaining cards (0)

Know

retry

shuffle

restart

0:00

Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

Normal Size Small Size show me how

Advanced Airway Lab

Surgery Seminar NG/OG Tube Placement

Question	Answer
Hypercapnia	CO2 levels high, symptomatic Hypercapnia is an indication for intubation. COPD, emphysema, asthma
Indications for Intubation	Sx hypercapnia, sx hypoxemia, airway protection against aspiration: comatose, neuro insult, overdose; general anesthesia, need to control and remove secretions --pulmonary toilet
Contraindications (relative) of Intubation	Awake patient, airway can be managed less invasively, severe airway trauma and obstruction --cricothyrotomy indicated, Cervical Spine injury. Don't forget RA
The Gold Standard of airway management	endotracheal intubation
LEMON law	Look externally, Evaluate the 3-3-2 rule, Mallampati score, Obstruction?, Neck Mobility
Class IV Mallampati Grade	Can't see airway. Class I, best visualization
Cormack-Lehane grades what?	View of Glottic Opening. Grade 1&2 have low failure rates. Grade 3&4 have high failure rates
Miller	Straight Laryngoscope blade
Mac	Curved Laryngoscope blade
Laryngoscope blade size for adults	3-0, or 4-0
Preoxygenation	Recommended for 5 minutes in controlled settings
Placement of patient for intubation	place patient in "sniffing" position -- align axis. Hyperextended neck.
what must you see to intubate?	the glottic opening
CO2 is acidic and should turn litmus paper (?)	Purple. Yellow means good ventilation
Tip of ETT Should be above	the Carina, don't want to be in the right mainstem.
Prolonged intubation attempts	can have hypotension, arrhythmias, vocal cord avulsion
Nasotracheal intubation may be useful in some situations:	Possibly spinal injury, clenched teeth, fractured jaw, oral surgery, airway swelling, obesity, arthritic preventing sniffing position
Contraindications to Nasotracheal tube	apneic patient, severe midface fractures or suspicision of basilar skull fx, coagulopathy (b/c nose if very vascular)
ideal patient position for Nasotracheal tube	Sitting and breathing patient
ET tube size range	.5-1
is a stylet used in the placement of a Nasotracheal tube?	no
How should insertion of Nasotracheal tube be timed?	Time brething and advance at beginning of inspiration. Expect patient to cough with placement
BAAM device can be used when?	In placement of Nasotracheal tube
Pediatric Airway characteristics	smaller, flexible, tongue is proportionately larger, epiglottis is floppy and round, glottic opening higher and anterior, vocal cords slant upward and closer to base of tongue, narrowest part is cricoid cartilage

Created by: ltm12

"Know" box contains:
Time elapsed:
Retries: