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23 Cards in this Set
- Front
- Back
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What are the standard sized ET tubes used for adults? |
Female: 7-8mm Male: 8-9mm |
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How long should you hyperventilate a patient prior to intubation? |
2 minutes/5 breaths |
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List the equipment required for endo tracheal intubation. |
ET tube Laryngoscope Macintosh/Miller blade Thomas tube holder Ribbon 20ml syringe Bugi Colormetric capnography BVM Stethascope Spencer Wells Mgill fawceps Oxygen Catheter Mount Suction device ODD |
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What size blade should be used for adults? |
3 - Normal size adult - 3 4 - Large Adult - 4 |
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How can you anticipate a diffucult airway? |
Look (short neck/obese/dental conditions) Evaluate 3-3-2 (Mouth opening - Tip of chin to Hyoid bone - Hyoid Bone to Thyroid notch) Mallampati 1=good 4=bad Obstruction Neck mobility |
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What are the key landmarks for intubation? |
Lips, teeth, tongue, hard palate, soft palate, uvula, tonsils, glottic opening, epiglotis, vestibular folds, vallecular, arytenoid cartilages |
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What are the indications for intubation? |
Basic airways failed Long term ventilations Airway burns Suctioning of the bronchial tree Inhalation risk Asynchronious cpr Patient has lost protective airway reflexes To prevent the aspiration of vomit |
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What are the hazards of intubation |
Total airway blockage Osophogeal intubation Patient resists Intubation of the right bronchus Clenched teeth (trismus) Airway burns Facial trauma Attachment too heavy |
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How long is the trachea? |
10-12 cm |
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How many rings of cartilage are in the trachea? |
15-20 |
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Describe the various feature of an ET tube. |
Top open end - 15mm Bottom end - bevilled Murphy's eye - small whole Pilot balloon with one way valve 2.5-10mm inside diameter |
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Name some further complications of intubation. |
Barotrauma Vocal chord damage Hypoxia Laryngospasm Laryngeal swelling |
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How can you improve the view of the glottic opening? |
Backwards Upwards Right Pressure |
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How far should the ET tube be inserted? |
So that the proximal end of the cuff is 2cm past the vocal chords. |
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How can you confirm correct placement of the ET tube? |
Auscultation of apexis and bases of lungs Ausculation of epigastric region Capnography ETCO2 Equal rise and fall of the chest ODD osophogeal detecting device |
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What should the CO2 levels be? |
35-45 mmHG 4-5.7 Kpa/% |
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What is ETCO2 |
End tidal CO2 is the concentration of CO2 at the end of an exhaled breath. |
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Describe the features of an Igel |
- Integral bite block - Non inflateable cuff which expands to fit the patients airway and provide a better seal - Tube for gastric secreations - sizes 3 (30-60) 4 (50-90) 5 (90+) - epiglottic rest to prevent epiglottic down folding |
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What are the disadvantaes of ET intubation? |
- It can take time and delay transport to difinitive care - It is not regularly practiced by paramedics and requires good skill and technique |
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What are the contra indication for ET intubation? |
- Patient is maintaining their own airway - Less invasive methods are effective - Epiglottitis - Unable to peform procedure in timely fasion |
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What is Epiglottitis? |
Inflammation of the epiglotis, normally caused by bacteria. Usually causes severe sore throat and difficulty swallowing. Can cause stridor in young children. |
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What are the hazards of extubation? |
- Patient cannot maintain their own airway - Laryngospasm or swelling of the airway - Aspiration of vomit |
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When so you remove the ET tube and why? |
The tube should be removed at the end of inhalation so that there is less risk of the patient inhaling vommit. |
