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14 Cards in this Set
- Front
- Back
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Elderly Considerations
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Decreased chest wall compliance
Decreased lung volume/strength Reduced sensitivity to hypoxia and carbon dioxide Co-morbidities Inadequate nutritional intake |
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ET tubes
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NT - nasal,
narrow tube, higher pressures, development of sinusitis leads to pneumonia, sepsis, probs w frontal sinus drainage OT - large diameter means less chance of infection, easier to suction, lower pressures |
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ET tube placement
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pt may start w/ nt tube but will be switched to ot tube bc is safer (lger diameter, easier to suction, less prob w/ pressures)
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sizes of et tubes
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cuffed ET tubes - adults bc it is blown up and seals upper from lower airway, stabilizes tube and prevents air from blowing out mouth
no cuff - babies and small children bc their airway is so small it is sealed off by tube stylet - flexible metal tube w silicone covering is inside the tube to stabilize the tube |
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tracheostomy tubes
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if necessary for long term resp assist
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bag valve resuscitator
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used to rescue airway. once et tube is established, attach to end of et tube.
* if person has et tube ALWAYS have bag valve present incase airway becomes blocked. |
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Other airway equipment
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topical anesthesia
laryngoscope handle/blade magill forceps - used in kids and adults in nt suction source suction catheter syringe to blow up cuff of tube lubricant securing device (ties tape) ppe - goggles, mask, gloves |
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Alternate Airway - verification of placement
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Chest wall movement (easier to place in rt lung)
Auscultation during use of manual resuscitative bag (before securing tube) CO2 detectors - fit on end of et tube (esophageal Chest x-ray - DEFINITIVE verifier! (all ppl w tubes should have an xray) call for xray as soon as tube is in right place |
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mechanical ventilation
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def - mov't of air in and out of the lungs mechanically
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positive pressure ventilators
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pressure - need to know how to op
volume - need to know how to op (most vents now are press and vol) time flow |
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negative pressure ventilators
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Iron lung - body is contained in a vacuum. have to be able to generate a breath to be in one. used in ppl w/ polio, ms
bc of pressure differential of atmosphere in tank and air in lungs, air is pulled into lungs |
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Scenario: Martha
pt seizes and vomits |
1. perform abcs - patent airway, pulses present, pt is breathing but is in respiratory distress
2. Signs - ^ resp rate, breathing is labored, ashen face color, responsive but lethargic 3. STAY IN ROOM 5. Call for help 6. have pct get o2 and suction set up if not present |
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Scenario pt 2: Martha
Vitals: 158/82 HR 112 RR 26, O2 Sat. 87% |
7. O2 100%
8. ECG monitor 9. continuous pulse ox 10. call the MD, using SBAR |
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SBAR
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Situation
-pt, name, location (I am calling about) -state specific problem (the problem i am calling about is) - ( i have assessed the patient personally) -(Vital signs are...) -nure states what the concern is (I am concerned about) |
