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10 Cards in this Set
- Front
- Back
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Describe the technique of extubation
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Suction oropharynx before pt is reactive, Administer 100% O2 for several minutes, deflate cuff, Apply positive pressure to bag and remove ETT, suction again if secretions present, apply mask w/ high-flow O2, check airway patency and adequate ventilation
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What is deep extubation?
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Extubation at the level of anesthesia that was necessary for surgical incision
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When is deep extubation used?
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In surgical cases where bucking on emergence would be detrimental (tympanomastoidectomy, vitrectomy/retinal surgery, asthmatics)
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What is the effect of extubating the trachea at a deep plane of anesthesia?
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Minimal CV response
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When is deep extubation contraindicated?
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Difficult airway, difficult intubation, high risk for aspiration
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Describe the technique for deep extubation
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Maintain volitile at 1 MAC, reverse muscle relaxant, administer 100% O2 for several minutes, suction airway [should not change HR], deflate cuff and monitor for signs of swallowing/coughing, insert oral/nasal airway if needed, extubate, turn off volitile, mask with 100% O2
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Describe a pediatric neck relative to an adult neck
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Anterior and cephalad larynx (c4 vs C6), long epiglottis, short trachea and neck
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What helps intubation with infants/young children? Why?
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Straight blade, due to anterior larynx
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What are the advantages of uncuffed ETTs in kids?
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Less pressure -> decreased post-intubation croup, leak prevents accidental barotrauma
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How is correct cuff size confirmed in peds?
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Easy passage of tube, leak at 10-25 cmH2O
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