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resp 131

airway management

write the 4 needs for artificial airways Relief of airway obstruction, facilitation for suctioning, protection of airway, prolonged artificial ventilation
what is the most common cause of upper airway obstruction? soft tissue obstruction
what sounds are made with upper airway obstruction? Stridor or snoring
write 6 other causes of upper airway obstruction bleeding, edema, foreign body, lesions, tumor, vomitus
How do you provide temporary relief from upper airhead? Head tilt or jaw thrust
reflexes pharyngeal- gag and swallowing
Laryngeal reflexes closure of epiglottis
tracheal-reflexes cough
carinal- cough
action for which the pharyngeal is responsible gag and swallowing
action for which the laryngeal reflex is responsible closure of epiglottis
what type of patient would a oropharyngeal airway be indicated unconscious patient only-Don't use if gag reflex is present may be used with bag-mask patients
what type of patient would a nasopharyngeal airway be indicated semi-conscious who gag with an oropharyngeal airway conscious patients unconscious patients with clenched jaws or traumatic damage to the mouth or mandible
steps on determining an airway cuff's minimal occlusive volume or MLV using a stethoscope (on the neck where the cuff is located) and a positive pressure breath (self inflating bag or manual breath from a mechanical ventilator), determine if there is a leak during inspiration at peak airway pressure. If no leak is heard, s
advantages of using a nasotracheal tube over an orotracheal tube easier to stabilize easier to suction equipment is more stable when attached
consideration that must be taken account when one places an artificial airway that will allow direct access to the lower airway circumvents the normal mechanisms to keep the lower airway sterile effectiveness of cough lost because of loss of functioning vocal cords can't communicate upper airway humididfication is lost-need to use a humidifier
complications related to the placement of an endotracheal tube vocal cord damage: A. superficial damage-Granuloma damage B. Trauma during intubation
Tracheal stenosis and tracheomalacia too much pressure in cuff or too large of a tube
complication related to E T tube placement Obstruction due to secretions tracheoesophageal fistula leak due to broken cuff tracheal necrosis
complication related to E T tube placement displacement into main stem bronchi
problem associated /overinflated cuff 18 torr or greater causes venous flow obstruction (congestion)
physical characteristics and markings found on orotracheal, nasotracheal, and tracheostomy tubes and their specific meanings and/or function made from PVC or silicone standard 15mm endotracheal tube adapter inserted into machine end pilot line (inflating tube for cuff) Pilot balloon -palpate to see how much air in cuff by feel body-top of cuff to bottom of endotracheal tube adaptor cuff
why is a water soluble lubricant used for inserting a nasal airway ease of insertion and prevent toxic reax from petroleum products
what complications might arise from the use of a nasopharyngeal airway sinusitis, epistaxis, gagging, air way obstruction
complications from improperly sized oropharyngeal airway gagging vomiting airway obstruction, septoperforation
what type of airway should be used on a semi consciousness patient in the recovery room nasopharygeal
what type of airway should be used to an elderly-nonintubated patient who requires frequent suctioning nasal trumpet
what type of airway should be used to a patient in cardiac arrest in the ER receiving BLS oropharyngeal and endotracheal tube
proper sequence for replacing the ETC 1. suction pharynx expose vocal chords with laryngoscope intubate w/endotrach tube insure proper placement and inflate cuff deflate ET cuff and remove ETC Be prepared for vomiting if pt vomits
what equip would employ when setting up a pt to receive 40% O2 w/a laryngeal airway in place O2 flow meter, nebulizer set at 40% corrugated tubing from nebulizer to water trap, from water trap corrugated tubing to a briggs T which hooks to the15mm adapter of the LMA
pt regaining consciousness and the laryngeal airway the patient has been removed. what should you do with the device put in biohazard bag and send to central supply for sterilization. or dispose of single patient use laryngeal airway.
what type of artificial tracheal would you use: Cardiac arrest oropharyngeal for bagging and endotracheal tube if pt came in wi combitube use that for bagging
C-1 fracture what kind of artifical tracheal would you use nasopharygeal for bagging followed by nasal intubation If not poss try cricothryroidotomy
you are changing a trache tube in pt w/no spont. resp. who is mech vent. you can't get tube in? take a pair of kellys and dilate the stoma and slip the tube in, or change the size of the tube, ventilate patient
16yr old quadriplegic with C7 fracture the cuff needs to be deflated and changed to a non cuffed type endotracheal tube
what type of artificial tracheal would you use?Cardiac Arrest Oro. for gagging and ET tube if pt came in w/combitube use that for bagging
3 yr old with epoiglottitis ET tube in surgery for controlled environ, or if unable to pass ET, then trach, tube or emergency cricothyroidotomy or percutaneous tracheotomy
pt with paralyzed vocal cords cuffed or uncuffed unfiniestrated trach tube
fractured jaw Nasopharygeal, if risk of aspiration use trach tube w/cuff
alert stroke pt who cannot cough nasal trumpet, if chronic use ET tube if very long term use trach tube or trach button
safety precautions that one should be taken during oral hygeiene of the intubated pt. 2 caregivers present, 1 for mouth care and 1 support of tube to prevent accidental extubation. Need manual resuscitator w/mask as we;; as intubation equipment
mrs. king, open heart surgery and is 20 hours post op describe how would assess her readiness mental status current vent settings vitals ECG Pulse Ox Vital capacity spont tidal volume H MIP Hemodynamic stability
mr. is intubated... tube is too small-need larger size increase fiO2 and increase volume on vent
pt with paralyzed vocal chords cuffed or uncuffed unfinestrated trach tube
pt w/dysphagia and chronic aspiration cuffed unfinestrated trach. tube
fractured jaw nasopharygeal, if rish of aspiration use trach tube w/cuff
mr kee is intubated ...... tube is too small need a larger size. Increase FIO2 and increase volume on vent
biggest problem associated w/ overinflated cuff 30 torr or greater? stops arterial capillary blood flow (ischemia)
problem associated with overinflated cuff of 5 torr or greater cuases lymphatic flow obstruction (edema)
what is the formula to convert ID to ODmm to French MM X 3.14
formula to determine catheter size in French {(IDmm X 3)/2}+2
Created by: rislas1