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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| Contraindications for Emergency AW managment | show 🗑
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| show | 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
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| Which pt's need AW emergency management? | show 🗑
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| PT is unable to protect AW adequately if | show 🗑
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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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| Signs of lower AW obstruction | show 🗑
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| show | Respiratory efforts w/no breath sounds or suggestion of air movement
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| Signs of apnea | show 🗑
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| Signs of Respiratory arrest | show 🗑
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| show | 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
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| Monitor Physiological variables during emergency management of AW | show 🗑
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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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| show | No. 8 or 8.5
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| ET tube size and distance from incisors for infant<1kg | show 🗑
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| ET tube size and distance from incisors for infant 1-2 kg | show 🗑
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| ET tube size and distance from incisors for infant 2-3 kg | show 🗑
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| show | Size 3.5-4.0 mm, Length 9-10 cm
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| show | Size 3.5-4.0 mm, Length 10-11 cm
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| show | Size 3.5-4.5 mm, Length 11-13 cm
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| ET tube size and distance from incisors for 3 yrs | show 🗑
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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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| show | Size 6.0-7.0 mm, Length 17-19 cm
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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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| show | No. 3 curved macintosh
or
Straight Miller laryngscope blade
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| show | 21-23 cm mark at the teeth
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| show | 19-21 cm mark at the teeth
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| show | Need for emergency surgical AW
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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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