Ch 8 Basic Airway

Front 1

Pulse Oximetry

Back 1

device that measures O2 saturation in peripheral tissue:
Sensor probe placed over peripheral capillary bed (fingertip, toe, ear lobe , heel of infants)
Sensor emitted a wavelength of light specific for Oxygenated hemoglobin (red) while another emits specific for deoxygenated hemoglobin (infrared)

Front 2

Causes of false pulse oximetry

Back 2

CO poisoning, Hypothermia, Fingernail polish

Front 3

100-95 %

Back 3

Normal

Front 4

94 - 91 %

Back 4

Mild hypoxia

Front 5

90-86%

Back 5

Moderate hypoxia

Front 6

85 %- Below

Back 6

Severe hypoxia

Front 7

Colorimetric End-Tidal CO2 Detector

Back 7

Changes colors when CO2 passes through

Front 8

An esophageal Detector Device-bulb style (EDD)

Back 8

-Squeeze bulb detector and apply to ET tube and release bulb
-If the bulb does not refill, the tube is improperly placed.
-If bulb refills easily upon release, it indicates correct placement.

Front 9

Oropharyngeal airways -OPA

Back 9

Never to be used in the presence of a gag reflex.
Correct sizing is important: can obstruct airway
Size from patients mouth to the angle of the jaw or earlobe

Front 10

Nasopharyngeal Airway

Back 10

May be used in the presence of gag reflex
Never used if suspect basilar skull fracture
Good for maxillofacial trauma or seizing patient.
Watch for bleeding
Sizing: slightly smaller than nostril and equal to the distance from nose to earlobe.

Front 11

Pharyngo-Tracheal
lumen airway-PtL

Back 11

2 tube system-
longer esophageal/Tracheal tube inside the shorter oropharyngeal tube
Can be inserted either in the esophagus or trachea
2 cuffs-oropharyngeal and

Front 12

Combi-Tube

Back 12

2 tube system
2 tubes combined together side by side
Can be inserted either in the esophagus or trachea
2 cuffs-oropharyngeal (100cc) and distal cuff (10-15cc)

Front 13

PtL & Combi Tube Indications

Back 13

-Apneic patient without gag reflex
-ET equipment or personnel unavailable
-Patient entrapment
-profuse bleeding into oropharynx

Front 14

PtL & Combi Tube Contradictions

Back 14

- < 16 years old
- under 5 ft. or over 6 ft 7”
- caustic ingestion
- Hx. of esophageal disease

Front 15

PtL & Combi Tube Advantages

Back 15

-functions in either the esophagus or trachea
-no face mask to seal
-blind insertion

Front 16

PtL & Combi Tube Disadvantages

Back 16

-oropharyngeal balloon does not totally protect trachea
-intubation around balloon is difficult
-cannot be used in patients with gag reflex

Front 17

Nasal Cannula

Back 17

40%- never> 6 lpm

Front 18

Venturi Mask

Back 18

24, 28, 35, or 40%

Front 19

Simple face mask

Back 19

40% - 60%

Front 20

Nonrebreather mask

Back 20

80% - 95%

Front 21

Ventilation Methods

Back 21

- Mouth-to-mouth
- Mouth-to-nose
- Bag-valve device
- Demand valve device
- Automatic transport ventilator

Front 22

Bag Valve mask- BVM

Back 22

-should be self filling
-no pop off valve on adult bags
-2 non rebreathing valves
-clear face piece
-reservoir attachment
-comes in neonatal- infant-child and adult sizes
-delivers 21% without reservoir
-90-95 % with reservoir
-Difficult to use - need training in proper use
tight seal difficult to obtain

Front 23

Lung/BVM Compliance

Back 23

When using BVM, refers to the stiffness or flexibility of the lung tissue

Front 24

Good compliance

Back 24

minimal resistance felt

Front 25

Poor compliance

Back 25

Difficult to bag patient.

Front 26

Suctioning Techniques

Back 26

-Wear protective eyewear, gloves,and face mask.
-Preoxygenate the patient.
-Determine depth of catheter insertion.
-With suction off, insert catheter.
-Turn on suction and suction while removing catheter(no more than 10 seconds).
-Hyperventilate the patient.

Front 27

Hazards of suctioning

Back 27

-hypoxia - limit to 10 seconds
-always hyperventilate prior and post suctioning
-cardiac dysrhythmias vagal stimulation causing bradycardia

Front 28

Demand Valve

Back 28

-delivers high pressure O2 by push button
-delivers 100% at 40-60 lpm
-can attach to EOA or other devices

Front 29

Disadvantages of demand valve

Back 29

-does not provide a feel for chest compliance
-can cause pneumothorax
-drains O2 tanks quickly
-should not be used with intubated patient

Front 30

Automatic ventilators

Back 30

-automatic, constant flow
can control tidal volumes and rate
-pop off valves prevent pneumothorax
-allows personnel to perform other tasks
-are very expensive

Front 31

Eupnea

Back 31

normal, quiet breathing

Front 32

Dyspnea

Back 32

difficult breathing

Front 33

Hyperpnea

Back 33

deep breathing

Front 34

Tachypnea

Back 34

rapid breathing

Front 35

Bradypnea

Back 35

slow breathing

Front 36

Apnea

Back 36

no breathing

Front 37

Hypoxia

Back 37

decreased O2 levels in the blood

Front 38

Cyanosis

Back 38

bluish color of the skin from insufficient O2 in the blood

Front 39

Orthopnea

Back 39

discomfort in breathing in the supine position

Front 40

Hyperventilation

Back 40

increased minute volume which results in a lowered CO2 level

Front 41

Hypoventilation

Back 41

reduced rate and depth of breathing

Front 42

Rales

Back 42

fine wet lung sounds leads to moisture in small airways

Front 43

Rhonchi

Back 43

harsh wet lung sound in large airways

Front 44

Snoring Respiration's

Back 44

harsh, inspiratory sound due to upper airway obstruction, usually the tongue

Front 45

Stridor

Back 45

harsh, inspiratory sound(seal bark) due to upper airway obstruction, usually croup)

Front 46

Nasal Flaring

Back 46

excessive widening of the nares on inspiration

Front 47

Tracheal Tugging

Back 47

retraction of the tissues of the neck due to airway obstruction

Front 48

Wheezing

Back 48

whistling through smaller airways due to edema of the mucous membranes lining the airway.

Front 49

Friction Rub

Back 49

distinct sound heard when 2 dry surfaces rub together

Front 50

Pleural rub

Back 50

creaking, grating sound made when inflamed pleural surfaces move during respiration

Front 51

Pulmonary edema

Back 51

fluid in the alveoli, usually due to left sided heart failure; also caused by chemical irritation, burns and near drownings