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15 Cards in this Set

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Manual resuscitators

Bag, Valve, Mask BVM


100% O2 capabilities


Reservoir


bag or Accumulator


flow meter has to be above 15 lpm


need to bag vigorisouly to blow of CO2



Proper placement of hands to hold resuscitator mask to patients face and perform head tilt maneuver

Manual Resuscitators

Adequate stroke volume


:700 to 1100 ml


Quick refill capabilities


Spontaneous breathing through 1 way valve


Tracheal airways

Two basic types


:Endotracheal tubes


::inserted through either mouth or nose, through larynx and into trachea


:Tracheostomy tubes


::inserted through surgically created opening in neck directly into trachea: tracheotomy


King of airways!


Endotracheal Tube

Endotracheal tube


:best emergency device for maintaining a secure airway


:provides route for Sx and prevents aspiration


Works well with PPV


Can be maintained for weeks


ETT tube

Murphy eye at end if tip gets occluded


Inflatable cuff to seal airway (hi V low P)


Pilot tube to cuff. (don't accidentally cut!)


Graduated in cm


Radio opaque stripe for X ray identification

Tracheal airways

Endotracheal tube and tracheostomy tube

Establishing an artificial airway

Procedure


:Orotracheal intubation


:Nasotracheal intubation


:tracheotomy


Orotracheal intubation

PROS


:Fastest, most direct


:Larger diameter can be utilized


:Minimal trauma


CONs


:Oral care difficult


:ETT leads to increased gag reflex


:less stable

Nasal intubation

PROS


:less gag reflex


:oral care easier


:ETT more stable


CONS


:smaller tube


:Necrosis of nasal tissue


Intubation Equipment

Endotracheal tube and stylet (pliable metal device, straightens the tube)


Laryngoscope


Sterile water soluable jelly


10 cc syringe to inflate cuff


Adhesive tape or tube fixation device


Bite blok to prevent biting oral ET tube


Suction equipment, bag mask, O2


Local anesthetic (lidocaine spray)


Stethoscope


Carlins tube is a double lumen endotracheal tube used for independent lung ventilation

Used for things like pneumothorax

Orotracheal intubation

Step 1, assemble and check equipment, batteries, blade, bulbs


Step 2, position patient: sniffing position


Step 3, preoxygenate and ventilate patient with BVM 100% O2, blow off PaCO2


Step 4, insert laryngoscope,


step 5, displace epiglottis to reveal the glottic opening


Step 6, visualize the glottis (opening into the trachea)


Step 7, Insert tube about 2 cm past the cords


Step 8, assess tube position (breath sounds, chest x ray, colorimeter)


:tip of tube should be 3 to 6 cm above the Carina


Laryngoscope

Blade and Handle


Blade


:has a flange, spatula, light and tip


:Curved blade (mactintosh)


:Straight blade (miller)


Fiber optic vs traditional laryngoscope


Blade size 0-1 for infant, size 2 from age 2 to 8 years old, size 3 from age 10 to adult, and size 4 for large adult


Laryngoscope blades

Miller or stragiht blade


:inserted to directly lift epiglottis


Mactintosh or curved blade


:inserted into vallecula and lifted to move the epiglottis indirectly


:usually easier to find cords with this blade

Assignment

White Clinical lab competencies


Chapter 21 page 461 to 467


Egan page 751 to 757


Workbook page 251 to 252