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Airway Management
Egan's Fundamentals in Respiratory Care Chapter 36
| Question | Answer |
|---|---|
| What is Cerebrospinal Rhinorrhea or otorrhea | Fracture causes CSF to come out of nose or mouth |
| What are the signs of a basal skull fracture (battle signs) | Racoon eyes, bruising behind ears |
| What is the thyroid cartilage also known as | Adam's Apple |
| What does arytenoid cartilages have attachment for | vocal cords |
| What are the ABCs of airway management | Airway, breathing, circulation (circulation is the most important) |
| What will occur after 0-1minutes without oxygen | cardiac irriability |
| what will occur after 0-4minutes without oxygen | brain damage is not likely |
| what will occur after 4-6minutes without oxygen | brain damage is possible |
| what will occur after 6-10minutes without oxygen | brain damage is very likely |
| what will occur after more than 10 minute without oxygen | irreversible brain damage |
| What are the 4 times of OPAs | Geudal, Berman, Brooks, COPA |
| which OPA is open at the sides of air movement | Berman |
| Are OPAs for conscious or unconscious patients | unconscious |
| What is the Brooks | OPA with 1 way valve to direct flow |
| What is the COPA | OPA with cuff |
| Who is indicated using the anti-anatomical OPA insertion | patients over 8 years old |
| who is indicated using the anatomical technique of OPA insertion | patients less than 8 years old |
| Is the nasal trumpet for conscious or unconscious patients | conscious patients |
| Are supraglottic airways for conscious or unconscious patients | unconscious patients |
| How is the size of LMA chosen | by the patients weight |
| Where is the King-LT placed | is sealed in the esophagus |
| Which balloon is inflated and which tube is used to ventilate when using a Combi-tube | when inserted in esophagus both balloons are inflated and the #1 blue tube is used to ventilate. when inserted in trachea the distal balloon is inflated and the #2 clear tube is used to ventilate |
| What is the inner and outer diameter of a BVM | inner= 15mm, outer= 22mm |
| What does the bag inlet valve do on a self inflating BVM | acts as a one way valve allowing air into the compressible unit |
| What does the patient valve do on a self inflating BVM | forces air into patients lungs and prevents rebreathing |
| How many breaths per minute should be given with a BVM | 10-13 BMP (1 squeeze every 5 seconds) |
| What is the macintosh blade | curved blade that is placed in the vellecula |
| what is the miller blade | straight blade that is intended to pick up the epiglottis (often used for neonatal) |
| What colours does the CO2 detector have | purple before detection, yellow in presence of CO2 |
| What are the average sizes of a ETT for males, females and children | adult= 8mm female= 7 1/2 children= age/4 +4 |
| how long should pre-oxygenation take place before intubation | 3-5 minutes |
| where should the ETT be placed | 2cm past vocal cords and 5cm above the carina |
| what is RSI | rapid sequence induction, is used for patients at high risk of aspiration |
| what are the classes of mallampati scores | 1- complete visualization 2- complete visualization of uvula 3- visualization only of the base of the uvula 4- soft palate is not visible at all |
| what is the acryonm BURP | stands for backward, upward, right ward pressure improves cormark lehane view by 1 full grade pushes thyroid cartilage |
| what are the grades of Cormack Lehane | (requires a laryngoscope) 1- full aperture 2- lower part of vocal cords visible 3- only epiglottis visible 4- epiglottis is not visible |
| what is the sellicks maneuver | pushes back on the cricoid to occlude the esophagus and aid in prevention of gastric aspiration |
| What is different about childrens larynx's | they larynx is more superior and is funnel shaped |
| what does the trigeminal nerve innervate | the nasal cavity |
| what does the glossopharygneal nerve innervate | the pharyngeal structures |
| what does the vagus nerve innervate | the superior laryngeal structures |
| What must be required to extubate | - VC must exceed 10ml/kg of IBW - PNIP must exceed -20cm H20 - arterial saturation must be above 92% - FiO2 must be less than 50% |
| What are the 2 methods of cuff leak | 1. deflate and see if the patient can breathe spontaneously around tube 2. deflate and assess the leak during a PPB with a manual resuscitator and inline pressure monometer (must be under 40cm H2O) |
| What is the most common design of cuff | high volume, low pressure |
| What is the minimal leak technique | listen over trachea while inflating cuff, and it is used for patients who can't tolerate any pressure |
| what is the minimal occluding volume technique | verify inflation of cuff regularly with cuff pressure monometer |
| what is the endobronchial tube (Uni-vent) | isolates left or right lung (left is more common) used in thoracic surgery |
| what is the endotrol tube | used for blind nasal intubation |
| how do you convert french to mm | ID= FR - 2 /4 OD= FR x 0.33 |
| what is the EVAC tube | it aids in removal of secretions from building up in the cuff |
| what is the foam cuffed tube | is a self inflating foam filled cuff often used in air transport |
| what is the hi-low jet | multi-lumen jet with humidity and monitoring. Only oral tubes available |
| what is the lanz tube | pressure regulating valve in pilot balloon that ensures pressure in cuff is limited to less than 25 cm H2O |
| what is the laser tube | a flexible, spiral stainless steel tube. the cuff is filled with saline or water and it is used fro laser surgical procedures |
| what is the RAE tube | has a preformed curve to keep connection away from surgical sites during surgeries around the head. Has oral or nasal specific tubes |
| What is a percutaneous | similar to a tracheostomy but is done bedside |
| What is the standard outer diameter of a tracheostomy tube | 15mm |
| what is the fenestrated trach | has a single or multi opening just above the cuff. Enhance speaking when cuff is deflated and the tube is capped |
| What is the jackson trach | a stainless steel or silver, has no cuff and is used for long term or permanent use |
| what is the passy muir speaking valve trach | the patient inspires via the inner lumen and expires around the outside of the tube through the vocal cords, enabling phonation |
| what is the trach button | it maintains the stoma opening for long term and permanent need |
| what is the montgomery T-tube | used for tracheal stenting and it is shaped like a T |
| What are the 4 types of video assisted intubating devices | the glide scope, the airtraq, the levitan scope, the mcgrath |
| how does the glide scope work | has an angulated design to view the anterior glottis |
| how does the airtraq work | has two seperate channels: optical channel is used to visualize the anatomy guiding channel is used to hold and lead the ETT |
| how does the levitan scope work | is a shaped stylet with a slight bend at the proximal cuff. Can be used with or without a laryngscope and it has an oxygen port for insufflation |
| what is the mcgrath | it is a fully portable video laryngscope |
| What is the Bougie | It has a coude tip used for tactile feel of tracheal rings is helpful for a patient that neck movement is contraindicated |
| what is an assistive stylet | it has a trach light to show an upper glow as a well defined circle of light just below the hyoid and above the thyroid cartilage |
| what two ways can a fast trach LMA be inserted | supraglottic or subglottic insertion |
| what is the bullard | it used an eye piece is designed to be used in patients where head and neck must be in neutral position |
| what is the KIS? | Kepler intubation system the worlds first intubating robot |
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