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Test 5 Theories

Ch 33 Egans, Persing 49-59

QuestionAnswer
Conditions requiring management of AW are impending or actual AW compromise Respiratory failure Need to protect AW
Indications for emergency AW managment AW EMG b/f et intubation, obstruction of AW, Apnea, coma penetrating neck trauma Cardipul arrest/unstable dysrythmias severe bronchospasm pulmonary edema narcotics foreign body obstruction choanal antresia in neonates apsiration or risk of
Contraindications for Emergency AW managment Pt is a DNR
Hazards & Complications of Emergency AW managment Failure to establish a patent AW, intuabte trachea or recognize esophogeal intubation Upper AW trauma, laryngeal & esophageal damage Aspiration C-spine trauma Unrecognized Bronchial intubation Eye injury Vocal cord paralaysis ET Tube Issues
Which pt's need AW emergency management? Pt inability to protect AW adequately (w*w/o respiratory distress) Partial or complete obstructed AW Apnea, maybe associated with cardiac arrest Hypoxemia, hypercarbia, or acidemia Respiratory distress
PT is unable to protect AW adequately if Coma Lack of gag reflex inability to cough May or may not be associated with respiratory distress
Sings of partially obstructed AW Ineffective pt effort to ventilate Paradoxial respiration stridor Use of accessory muscles PT pointing to neck choking motions Cyanosis and distress
Signs of lower AW obstruction All listed for upper AW obstruction Wheezing
Completely obstructed AW signs Respiratory efforts w/no breath sounds or suggestion of air movement
Signs of apnea No respiratory efforts seen May be associated with Cardiac arrest
Signs of Respiratory arrest Elevated RR High or low ventilatory volumes Signs of Sypathetics nervous system hyperactivity
Monitor Clinical signs during emergency management of AW Lvl of consciousness Presence of & character of breath sounds Vent ease Symty & amt of chest movmt Skin color & character (Temp & diaphoresis) Upp AW snds (crowing, snoring, stridor) Exce secretions debris in AW Epigastric snds retractions na
Monitor Physiological variables during emergency management of AW Vent frqy, VT, and AW pressure presence of CO2 in exhaled gas HR & Rhythm P/Ox ABG values CXS
ET position accuracy check: Bilateral BS Symmetric chest movement Absence or ventil sounds of epigastrium Condensate in tube, correlates with exhalation Visualization of tube through vocal cords Esophagel detector devices Capnometry endoscopic visualization
Generally a woman is intubated with what size? No. 7 or 7.5
Generally a man is intubated with what size? No. 8 or 8.5
ET tube size and distance from incisors for infant<1kg Size 2.5 mm, Length 6.5-8 cm
ET tube size and distance from incisors for infant 1-2 kg Size 3.0 mm, Length 7-8 cm
ET tube size and distance from incisors for infant 2-3 kg Size 3.5 mm, Length 8-9 cm
ET tube size and distance from incisors for infant 4 kg Size 3.5-4.0 mm, Length 9-10 cm
ET tube size and distance from incisors for 6 months Size 3.5-4.0 mm, Length 10-11 cm
ET tube size and distance from incisors for 18 months Size 3.5-4.5 mm, Length 11-13 cm
ET tube size and distance from incisors for 3 yrs Size 4.5-5.0 mm, Length 12-14 cm
ET tube size and distance from incisors for 5 yrs Size 4.5-5.0 mm, Length 13-15 cm
ET tube size and distance from incisors for 6 yrs Size 5.5-6.0 mm, Length 14-16 cm
ET tube size and distance from incisors for 8 yrs Size 6.0-6.5 mm, Length 15-17 cm
ET tube size and distance from incisors for 12 yrs Size 6.0-7.0 mm, Length 17-19 cm
ET tube size and distance from incisors for 16 yrs or small woman Size 6.5-7.0 mm, Length 18-20 cm
ET tube size and distance from incisors for women (AVG) Size 7.5-8.0 mm, Length 19-21 cm
ET tube size and distance from incisors Size 8.0-9.0 mm, Length 21-23 cm
What blade is commonly used to intubate adults? No. 3 curved macintosh or Straight Miller laryngscope blade
Generally, where should the Orotracheal tube be initially inserted in men? 21-23 cm mark at the teeth
Generally, where should the Orotracheal tube be initially inserted in women? 19-21 cm mark at the teeth
Absolute contraindication for percutaneous dilation tracheostomy Need for emergency surgical AW
Relative contraindication for percutaneous dilation tracheostomy Children <12 yrs poor landmarks secondary to body habitus, abnormal anatomy, or occluding thyroid mass PEEP> 15 cm h20 Coagulopathy Pulsating blood vessel of trach site Limited C-spine flex Hx diff intubation infection, burn, malignancy at trach si
Created by: Kemashea