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48 Cards in this Set
- Front
- Back
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What patient characteristics may mean a difficult mask fit? |
Men: large faces, beards Women: small face, small/no chin |
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What is a potential problem with using a head strap with a face mask? |
Too tight can lead to nerve injury |
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What modifications to mask technique can help give better ventilation? |
Two hands vs. one Oral airway |
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Before which step of induction must test ventilation with the mask occur? |
Muscle relaxation |
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What three axes are aligned in the "sniffing" position? |
Oral Pharyngeal Laryngeal |
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What is the goal of preoxygenation? |
Denitrogenation and oxygenation of the functional residual capacity |
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What is a "vital capacity breath"? |
Biggest breath the patient can take |
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How much apnea can 3-5 minutes of normal breathing preoxygenation (100% O2, 5L+ flow) provide? |
Up to 10 minutes in a healthy patient |
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How much apnea can 4 vital capacity breaths over 30 seconds provide? |
Up to 5 minutes in a healthy patient |
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What patients would require the shortened preoxygenation technique (4 VC breaths/30 seconds)? |
RSI cases Crash c-sections Etc |
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What supplies are included in an airway setup? |
2 laryngoscope + blades (one Mac, one Miller) Oral/nasal airways + Tongue depressor ETT tubes: 2 sizes + Stylet Suction Ambu-bag LMA (#4) |
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What size ETT can be placed through a #4 LMA? |
6.0 ETT |
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What size ETT can be placed through an intubating LMA? |
8.0 ETT |
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What region of the airway does laryngospasm occur in? |
Supraglottic |
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What will occur from using an oral airway in an unsedated person? |
Laryngospasm |
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What is the function of a nasal airway? |
Provides a passageway behind the relaxed and obstructing tongue |
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What is the most critical preparatory step to using a nasal airway? |
Lubrication |
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What airway adjunct is best tolerated during light anesthesia? |
Nasal airway |
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What caution must be exercised if a patient reports nasal allergies? |
Hypertrophic turbinates can easily bleed if damaged |
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What are contraindications to nasal airway use? |
Nasal/basal skull fractures Adenoid hypertrophy Anticoagulation |
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What are the most appropriate ETT sizes for women? |
7.0 and 6.5 ETT |
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What are the most appropriate ETT sizes for men? |
7.5 and 8.0 ETT |
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What is the optimum position for the ETT? |
4cm above the carina and 2cm below the vocal cords |
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What size ETT might you choose for a patient who will need to remain intubated? |
One that is slightly larger |
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What potential problem with intubation will ETCO2 not indicate? |
Right mainstem intubation |
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What intubation modifications do patients with rheumatoid arthritis require and why? |
Awake intubation due to altered cervical physiology that prohibits extension |
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What areas does the recurrent laryngeal nerve supply sensory innervation to? |
Larynx below the cords |
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What areas does the internal branch of the superior laryngeal nerve supply sensory innervation to? |
Vocal cords Larynx above the cords |
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What areas of the airway does the glossopharynx provide sensory innervation to? |
Posterior 1/3rd of the tongue Oropharynx down to vallecula |
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What nerve provides motor innervation to the cricothyroid muscle? |
External branch of superior laryngeal nerve |
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What nerve provides motor innervation to almost all of the intrinsic muscles of the larynx? |
Recurrent laryngeal nerve |
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What cardiovascular effects can laryngoscopy and intubation cause? |
Hypertension Tachycardia Myocardial ischemia
(All related to duration/force of DVL) |
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What respiratory effects can laryngoscopy and intubation cause? |
Laryngospasm Bronchospasm |
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What agents work to increase success of laryngoscopy and intubation? |
Inhalation agent with N2O Narcotics Bronchodilators Topical anesthesia |
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What are some complications of tracheal intubation? |
Trauma Misplaced ETT (esophageal, endobronchial) ETT ignition (?!) Laryngospasm Croup Sore throat |
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What four categories can the induction sequence be roughly divided into? |
Set-up/preoxygenation Sedation Intubation Follow-through |
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What steps come during the setup stage of induction? |
Pre-oxygenation Position patient supine, in sniffing position Monitors on patient and working |
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What steps come during the sedation stage of induction? |
Push induction agent Check lash reflex Test ventilation Check NMB monitor is working |
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What steps come during the intubation stage of induction? |
Push paralytic drug Tape eyes closed Continue ventilation until loss of twitches Laryngoscopy/intubation |
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What steps come during the follow-up stage of induction? |
Confirm ETT placement Continuous ventilation by bag or ventilator Start maintenance anesthetic Tape the ETT |
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How do we confirm ETT placement? |
Bilateral breath sounds Chest rise and fall ETCO2 monitor |
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What level of sedation should be used with most patients requiring airway blocks? |
Minimal - just enough to get through it |
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What is the function of airway blocks? |
Abolish or blunt airway reflexes Provide patient comfort during airway instrumentation |
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What are possible complications of airway blocks? |
Systemic toxicity Hematoma formation |
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What nerve does the transtracheal block affect? |
The recurrent laryngeal nerve |
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What area of the airway does the transtracheal block numb? |
Trachea below the vocal cords |
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What negative effects of laryngoscopy/bronchoscopy does the transtracheal block prevent? |
Gag reflex Hemodynamic responses |
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How much of what drug do we use for a transtracheal block? |
3-4mL of 2-4% lidocaine |
