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17 Cards in this Set
- Front
- Back
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What are the priorities of primary and secondary survey?
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Primary: assess and manage life-threatening injuries
Secondary: Head-to-toe exam, search for non-lifethreatening injuries |
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What is the first goal of airway management?
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Assess and establish patent airway (while protecting C-spine)
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How do you recognize airway obstruction?
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Look, listen (voice, hoarseness, breath sounds, gurgling) and feel
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How do you establish a patent airway?
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1. suction to remove debris
2. jaw thrust/chin lift 3. insert oropharyngeal or nasopharyngeal airway 4. If still no open airway try a Laryngeal Mask Airway (LMA) |
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What is an LMA?
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Laryngeal Mask Airway - fits in back of throat and makes a seal with NO airway protection. Use only if can't insert other airway devices
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What is a definitive airway?
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Tube that provides:
Patent airway Protection from aspiration Ability to deliver gas by pressure to the lungs |
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What are to major categories of definitive airways?
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Above the cords: endotracheal tube
Below the cords: cricothyroidotomy, tracheostomy |
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What are the indications for needing a definitive airway?
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Patency
Protection Positive pressure ventilations (oxygenation + ventilation) Pulmonary toilet (suction secretions) Pharmacology (deliver drugs) |
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How do you manage the airway in an elective surgery patient?
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1. Put in sniffing position
2. Anesthetize (hypnosis/paralysis) 3. Ventilate on 100% O2(jaw thrust + mask +/- oral airway) 4. Intubate on 100% O2 5. Confirm correct placement of ETT |
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How do you confirm a definitive airway is in place?
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Visualize tube going in
End-tidal C02 monitor Chest rising Equal air entry Condensation on tube Bronchoscopy Chest x-ray (does NOT confirm definite airway but does help see position of tube) |
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How do you manage an airway in a trauma patient?
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C-spine immobilization
Suction debris Modified jaw thrust and determine if airway is patent Insert airway if not patent Insert ETT if indicated Confirm ETT is in |
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Once a patent and protected airway is established (A), what next?
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B = breathing (ventilation). Determine if patient is:
Not breathing at all Breathing adequately Breathing inadequately |
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What do you do if a patient is breathing?
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Apply an oxygen mask and monitor for deterioration
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What do you do if a patient is not breathing AT ALL
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Ensure patent airway
Ventilate patient (bag mask or ventilator) Determine reason for apnea |
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What do you do if a patient is breathing, but inadequately?
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Ventilate patient (bag mask or ventilator)
Determine etiology of inadequate ventilation |
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What are possible causes of inadequate breathing?
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Brain injury (trauma, drugs, medications)
Spinal cord injury Chest wall injury (ribs) - pain/mechanics Pleura problem (pneumothorax, hemothorax) Lung problem (contusion, laceration, aspiration) |
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How do you assess ventilation?
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Look: resp rate/distress, end tidal volume, symmetrical chest rise
Listen: to what patient says (pain, SOB), to lungs Feel: chest wall (fractures, subcutaneous empyema, etc.) Measure: O2 saturation, ABG, CXR |
