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23 Cards in this Set
- Front
- Back
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Pts at high risk for airway obstruction or respiratory insufficiency (4)
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1 Decreased level of consciousness
2 Cardiorespiratory disease 3 head/neck disorders 4 major trauma |
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Exceptions to airway mgt as first priority (3)
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1 If Vfib or PVT, defib first.
2 If pulseless pt with witnessed cardiac arrest and no defibrillator available, do precordial thump first. 3 Defib immediately if pulseless and defib available. |
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Most suscessful means of endotracheal intubation
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Rapid sequence intubation
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5 indications for airway management
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1 Patency
2 Protection 3 Oxygenation 4 Ventilation 5 Treatment |
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Drugs that can be administered through endotracheal tube (5)
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NAVEL
Narcan Atropine Versed Epinephrine Lidocaine |
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Steps in evaluating airway
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1 Assessment of Airway & breathing (Inspect, palpate, ascultate)
2 Manual opening (chin-lift, jaw-thrust) 3 Suction (Yankauer sunction tip) 4 Oxygen 5 Ventilation 6 Temporizing airway management devices |
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Airway management device in pts who snore or have tightly clenched teeth. Best for pts somewhat sedated who do not require definite airway management.
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Nasopharyngeal airway.
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Pt who tolerate an oropharyngeal airway without gagging are demonstrating_________________.
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inability to protect their airway.
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What is laryngeal mask airway used for?
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Seals off laryngeal opening, allowing ventilation through tube.
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What is transtracheal jet ventilation?
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Rescue method involving puncturing the cricothyroid membrane and delivering positive pressure oxygen. Helpful in kids<8 b/c emegency cricothyrotomy is contraindicated.
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Key features of History before airway management in non-emergent patients. (5)
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AMPLE
Allergies Meds Past med hx Last meal Events of recent illness |
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5 types of definitive airway management techniques
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Immediate
Oral awake Rapid Sequence Intubation Nasotracheal Cricothyrotomy |
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When is immediate airway technique used?
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Pt is arrested or in pre-arrested state
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When is Rapid Sequence Intubation used?
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1. Pt with good external anatomy and assumed good internal anatomy
2. Pt with good/bad external anatomy and questionable internal anatomy with glottis visualized |
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When is oral awake intubation technique used?
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Pt not in arrest
Has questionable internal anatomy (ext anat is good/bad) Glottis not visualized |
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When is nasotrachael intubation used?
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External anatomy bad
Internal anatomy assumed good |
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Anatomic factors predictive of difficult airway (7)
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Short neck
Kids Big Tongue Small jaw Poor neck extension Prominent upper incisors Bearded pts |
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Clinical factors predictive of difficult airway
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1 cervical spine immobilization
2 blood, vomit, secretions in airway 3 airway edema 4 Facial edema 5 Laryngeal trauma 6 Combative pts |
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How to access status prior to intubation?
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1. Look for cervical spine immobilization, emesis, facial trauma.
2. 3 External anatomic relationships: a. Mallampati score b. thyromental distance c. Neck extension (30 deg or greater) 3 Assessment of internal anatomy by clnical conditions p. 25 |
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Describe Mallampati classification.
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Class I:Soft palate, uvula, fauces, pillars visible
Class II: No pillars visible. III: Soft palate & base of uvula visible IV: hard palate only visible. Class 1 and 2: no difficulty. Class 3: moderate difficulty Class 4: Severe difficulty. |
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Endotrachael intubation is associated with what 2 symptoms in the majority of adult pts.
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hypertension and tachycardia
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Side effect of intubation common in children?
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bradycardia. Atropine tx.
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side effect of general anesthetic agents used in intubation?
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hypotension
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