Ch 33 Egans, Persing 49-59
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show | AW compromise
Respiratory failure
Need to protect AW
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Indications for emergency AW managment | show 🗑
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show | Pt is a DNR
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Hazards & Complications of Emergency AW managment | show 🗑
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show | 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
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show | Coma
Lack of gag reflex
inability to cough
May or may not be associated with respiratory distress
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show | Ineffective pt effort to ventilate
Paradoxial respiration
stridor
Use of accessory muscles
PT pointing to neck
choking motions
Cyanosis and distress
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show | All listed for upper AW obstruction
Wheezing
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Completely obstructed AW signs | show 🗑
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show | No respiratory efforts seen
May be associated with Cardiac arrest
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show | Elevated RR
High or low ventilatory volumes
Signs of Sypathetics nervous system hyperactivity
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Monitor Clinical signs during emergency management of AW | show 🗑
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show | Vent frqy, VT, and AW pressure
presence of CO2 in exhaled gas
HR & Rhythm
P/Ox
ABG values
CXS
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show | 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
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Generally a woman is intubated with what size? | show 🗑
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Generally a man is intubated with what size? | show 🗑
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show | Size 2.5 mm, Length 6.5-8 cm
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show | Size 3.0 mm, Length 7-8 cm
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show | Size 3.5 mm, Length 8-9 cm
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show | Size 3.5-4.0 mm, Length 9-10 cm
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ET tube size and distance from incisors for 6 months | show 🗑
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ET tube size and distance from incisors for 18 months | show 🗑
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show | Size 4.5-5.0 mm, Length 12-14 cm
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ET tube size and distance from incisors for 5 yrs | show 🗑
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show | Size 5.5-6.0 mm, Length 14-16 cm
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show | Size 6.0-6.5 mm, Length 15-17 cm
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ET tube size and distance from incisors for 12 yrs | show 🗑
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ET tube size and distance from incisors for 16 yrs or small woman | show 🗑
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show | Size 7.5-8.0 mm, Length 19-21 cm
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ET tube size and distance from incisors | show 🗑
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What blade is commonly used to intubate adults? | show 🗑
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Generally, where should the Orotracheal tube be initially inserted in men? | show 🗑
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show | 19-21 cm mark at the teeth
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Absolute contraindication for percutaneous dilation tracheostomy | show 🗑
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show | 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
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