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This comprehensive overview covers airway management techniques and related medical conditions, including intubation, suctioning, foreign body obstruction, facial trauma, opioid overdose, respiratory disorders, and airway procedures. It provides valuable information for students preparing for exams or studying airway management.
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Potential effects of orotracheal intubation. - Correct Answer-Secure airway, Protection against aspiration. Bleeding, hypoxia laryngeal swelling, laryngospasms, vocal cord, mucosal necrosis, barotrauma. Potential effects of moving an intubated patient. - Correct Answer-With a firmly secured tube the tip of the ET tube can move as much as 2 inches with head flexion and extension; with hyperflexion the tube can be pulled from the trachea completely. Hyperextension can cause the ET tube to be pushed further into the trachea. Consider C-collar to keep the head in neutral position. When to exubate a patient? - Correct Answer-Patients are rarely extubated in the prehospital setting. The only reason to consider extubation is if the patient is extremely intolerant of it or the ET tube is placed incorrectly. (Extremely combative, gagging or retching). It is typically safer to sedate the patient rather than extubate. Before performing field extubation, you should contact medical control or follow local protocols. Potential effects of overinflation of the distal cuff. - Correct Answer-Overinflation of the distal cuff may cause tissue necrosis of the tracheal wall. Indications for airway suctioning. - Correct Answer-When the patient's mouth or throat becomes filled with vomit, blood or secretions. Audible gurgling. Gold standard for successful intubation. - Correct Answer-The gold standard is endotracheal intubation; Gold standard for evidence of successful intubation is in-line capnography. Indications for direct laryngoscopy and magill forceps. - Correct Answer-If you are unable relieve a severe airway obstruction in an unresponsive patient with basic techniques. Have Magill forceps available should you need to guide the ET tube between the vocal cords or if you encounter a foreign body obstruction during laryngoscopy. Potential complications of endotracheal intubation. - Correct Answer-Bleeding, hypoxia, laryngeal swelling, laryngospasm, vocal cord damage, mucosal necrosis, and barotrauma. Anatomical place of a Miller blade. - Correct Answer-The straight laryngoscope blade (Miller) is designed so that its tip will extend beneath the epiglottis and directly lift it up.
Anatomical placement of a Macintosh blade. - Correct Answer-Curve of blade conforms to tongue and pharynx. The tip of the blade is placed in the vallecula. Indications for nasotracheal intubation. - Correct Answer-Nasotracheal intubation is indicated for patients who are breathing spontaneously but require definitive airway management to prevent further deterioration of their condition. Responsive patients and patients with an altered mental status and an intact gag reflex who are in respiratory failure because of conditions such as COPD, asthma, or pulmonary edema. Volume of the distal cuff of a endotracheal tube. - Correct Answer-5-10 mL Correct tube placement confirmation. - Correct Answer-1. Visualizing the the ET tube passing between the vocal cords.
In acute hypoventilation syndrome, patients usually feel as though they can't breathe at all. Tx of the Asthma patient. - Correct Answer-Bronchospasm: Treat with bronchodilator Bronchial edema: Treat with corticosteroids. Increased mucus production: Treat with hydration, mucolytics, and expectorants. Shark finning - Correct Answer-A shark fin capnographic waveform indicates bronchospasms. Signifies difficulty with exhalation and incomplete alveolar emptying. Indications for positive pressure ventilation. - Correct Answer-Patients who are breathing inadequately; too fast or too slow with reduced tidal volume (shallow breathing). Irregular breathing pattern Signs of altered mental status and inadequate minute volume. Accessory muscle use and labored breathing. Complications of too fast or forceful BVM ventilations. - Correct Answer-Gastric distension (and associated risks of vomiting and aspiration), and decreased venous return to the heart (preload) due to increased intrathoracic pressure. Corrective action for low or high ETCO2. - Correct Answer-Low: Due to hyperventilation, decrease ventilatory rate. High: Due to hypoventilation, increase ventilatory rate. Surfactant. - Correct Answer-A liquid protein substance that coats the alveoli in the lungs, decreases alveolar surface tension, and keeps the alveoli expanded; a low level in a premature infant contributes to respiratory distress syndrome. external respiration - Correct Answer-External respiration pulmonary respiration) is the process of exchanging oxygen and carbon dioxide between the alveoli and blood in the pulmonary capillaries. Respiratory acidosis - Correct Answer-Respiratory acidosis is always related to hypoventilation. Decreased lung tidal volume reduces the amount of CO2 that is exhaled, causing hypercapnia (increased CO2) respiratory alkalosis - Correct Answer-Respiratory alkalosis is associated with conditions that result in hyperventilation.
Increased respiratory rate decreases the amount of circulating carbon dioxide in the body. Hyperventilation accompanied by carpopedal spasm is a classic sign of respiratory alkalosis. Indications for albuterol nebulizer. - Correct Answer-Bronchospasms ( COPD, Asthma, Burns, Pneumonia, Anaphylaxis), Hypokalemia. Pulmonary Embolism S/S; Tx. - Correct Answer-Sudden dyspnea and cyanosis, sharp pain in the chest. Cyanosis that doesn't resolve with oxygen therapy, blood clot in legs. Tx: Anticoagulants S/S of CHF (left sided) - Correct Answer-Failure of the left ventricle causes an accumulation of fluid in the pulmonary system (pulmonary edema) Pulmonary edema (fluid in lungs) Dyspnea Orthopnea (inability to breathe while lying flat) Abnormal lung sounds (crackles, rales) Hypoxemia ALOC S/S of hyperventilation syndrome - Correct Answer-Rapid respiratory rate, carpopedal spasms. Tx for benzo overdose - Correct Answer-Airway maintenance, cardiorespiratory monitoring and support. IV fluids. Flumazenil, Activated charcoal. Physiological effects of respiratory failure - Correct Answer-Acute respiratory failure occurs when fluid builds up in the air sacs in your lungs. When that happens, your lungs can't release oxygen into your blood. In turn, your organs can't get enough oxygen-rich blood to function. You can also develop acute respiratory failure if your lungs can't remove carbon dioxide from your blood. Respiratory failure happens when the capillaries, or tiny blood vessels, surrounding your air sacs can't properly exchange carbon dioxide for oxygen. The condition can be acute or chronic. s/s of aspiration - Correct Answer-Gurgling, coughing, feeling that something is stuck in throat, wheezing, trouble breathing.
Indications for needle cricothyrotomy - Correct Answer-The inability to ventilate the patient by other, less invasive techniques; Massive maxilofacial trauma; inability to open the patient's mouth; uncontrolled oropharyngeal bleeding. S/S of ammonia inhalation - Correct Answer-Swelling and irritation of the upper airway. If the substance gets in the patient's eyes, they eyes will burn, feel inflamed and irritated. S/S of epiglottitis - Correct Answer-Severe, rapidly progressive inflammation of the epiglottis, may be fatal due to sudden airway obstruction. Sore throat, fever, drooling, hoarseness, purposeful hyper extension of the neck. Laryngotracheitis (Croup) - Correct Answer-Condition characterized by stridor, hoarseness and a barking cough that most commonly occurs in infants and children S/S of emphysema - Correct Answer-Barrel chest, tachypneic, pursed lip breathing, increased I/E ratio, abdominal muscle use, JVD. S/S of pneumonia - Correct Answer-Weakness, productive cough, fever, sometimes chest pain that worsens with coughing, shaking chills, crackles in the lungs, tactile fremitus, sputum production. Respiratory drive in a COPD patient. - Correct Answer-Hypoxic Drive: state in which a person's stimulus to breathe comes from a decrease in PaO2 rather than from the normal stimulus, an increase in PaO2. S/S of spontaneous pneumothorax - Correct Answer-Tachycardia, low SPO2, cyanosis, wheezing, pain/swelling in 1 or both legs, decreased lung sounds in injured lung, shortness of breath. S/S of bronchoconstriction and treatment - Correct Answer-Coughing, wheezing, chest pain or tightness. Tx: Bronchodilator; albuterol, short acting beta agonists, inhaled corticosteroids. S/S of polycythemia - Correct Answer-Caused by reduced blood flow - Plethora; Overproduction of red blood cells. Ruddy complexion; Fatigue; Dizziness; Headache. S&S of acute respiratory distress syndrome - Correct Answer-Caused by diffuse damage of the alveoli, perhaps as a result of shock, aspiration, pulmonary edema, barotrauma or a hypoxic event. S/S labored and rapid breathing, general weakness, low BP.
S/S of chronic bronchitis - Correct Answer-Excessive mucus production, chronic/recurrent productive cough, wheezing. Commonly a heavy smoker. Overweight, blue complexion. Hypercapnia, hypoxemia. S/S of cystic fibrosis - Correct Answer-A genetic disorder of the endocrine system that makes it difficult for chloride to move through cells. Primarily targets respiratory and digestive system. S/S: Increased production of mucus in the lungs and digestive tract, recurrent resp infections. Pediatric: Tachypnea, chest pain and crackles, accessory muscle use, nasal flaring. S/S and tx of airway burns - Correct Answer-Visible airway swelling, stridor, supraglottic trauma, burns to head/neck/face. Tx: airway management via BVM, followed by intubation if necessary. S/S of reactive airway disease (Asthma) - Correct Answer-Bronchospasm; Tx: Bronchodilator Airway/Bronchial edema; Tx: Corticosteroids Increased mucus production; Tx: Water and expectorants. Assessment and management of tracheostomy tubes. - Correct Answer-Tube placed within the stoma. Can oxygenate through the tube via attachment or placing and oxygen mask over the tube. Pt's may experience sudden dyspnea due to thick secretions within the tube. Suction the tube as you would a stoma. If the tube becomes dislodged, attempt to replace it. If you are unable to, move forward with an ET tube and insert it through the stoma. 0.5 to 0.75 inches in depth. Auscultate lungs to confirm placement. Assessment and management of stoma. - Correct Answer-Monitor stoma and make sure it doesn't become occluded with secretions. Suctioning may be required.( seconds at a time). Inject 3 mL saline and suction with catheter. Stoma ventilation: Infant or child size mask over stoma. Ensure adequate seal. Seal mouth and nose upon inhalation and release at end of each ventilation. (Exhalation through upper airway) Requires two rescuers.
S/S of subcutaneous emphysema - Correct Answer-Subcutaneous emphysema occurs when air infiltrates the subcutaneous (fatty) layers of the skin is characterized by a "crackling sensation" when palpated. Can be a result of cricothyrotomy tube misplacement. right mainstem intubation - Correct Answer-Endotracheal tube enters right main stem bronchus. Unequal breath sounds; uneven chest rise and fall. What are the 3 main items that an end-tidal CO2 monitor measures? - Correct Answer- Metabolism, perfusion and ventilation.