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Airway Management
Airway Management
107
Other
Professional
10/26/2008

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Cards

Term
Upper Airway
Definition
Nasal cavity, oral cavity, pharynx
Term
Lower Airway
Definition
Bronchi, alveoli, lung parenchyma, pleura
Term
Pneumothorax
Definition
the presence of gas or air in the plural cavity
Term
Narrowest part of adult airway
Definition
glottis
Term
Narrowest part of pediatric airway
Definition
cricoid cartilage
Term
Extubation
Definition
removing a tube from a body opening
Term
Sepsi
Definition
the body's metabolic demand for oxygen exceeds the patient's ability to supply it
Term
Paradoxical Breathing
Definition
assymetrical chest wall movement that lessons respiratory efficiency
Term
Flail Chest
Definition
defect in the chest wall that allows a segment to move freely, causing paradoxical chest wall movement
Term
Cyanosis
Definition
Bluish discoloration form lack of blood flow/oxygen
Term
Dyspnea
Definition
An abnormality of breathing rate, pattern, or effort
Term
Hypoxia
Definition
Oxygen deficiency
Term
Anoxia
Definition
The absence or near-absence or oxygen
Term
Coughing
Definition
Forceful exhalation of a large volume of air from the lungs. This performs a protective function in expelling foreign materials from the lungs
Term
Sneezing
Definition
Sudden, forceful exhalation from the nose
Term
Hiccoughing
Definition
Sudden inspiration caused by spasmodic contraction of the diaphragm with spastic closure of the glottis.
Term
Sighing
Definition
Slow, deep, involuntary inspiration followed by a prolonged expiration
Term
Grunting`
Definition
A forceful expiration that occurs against a partially closed epiglottis
Term
Pulsus Paradoxus
Definition
Drop in blood pressure of greater than 10 torr during inspiration
Term
Kussmaul's Respirations
Definition
Deep, slow or rapid, gasping breathing commonly found in diabetic ketoacidosis
Term
Cheyne-Stokes Respirations
Definition
Progressively deeper,faster breathing alternating with shallow,slower breathing indicating brainstem injury
Term
Biot's Respirations
Definition
Irregular pattern of rate and depth with sudden, periodic episodes or apnea, indication increased intracranial pressure
Term
Agonal Respirations
Definition
Shallow, slow infrequent breathing, indicating brain anoxia
Term
Snoring
Definition
Results from partial obstruction of the upper airway by the tongue
Term
Gurgling
Definition
Results from the accumulation of blood, vomitus, or other secretions in the upper airway
Term
Stridor
Definition
A harsh high-pitched sound heard on inhalation, associated with larygeal edema or constriction
Term
Wheezing
Definition
A musical, squeaking, or whistling sound heard in inspiration and/or exhalation, associated with bronchiolar constriction
Term
Quiet
Definition
Diminished or absent breath sounds are ominous finding and indicates a serious problem with the airway, breathing, or both
Term
Crackles (Rales)
Definition
A fine, bubbling sound heard in inspiration, associated with fluid in teh smaller bronchioles
Term
Rhonchi
Definition
A coarse, rattling noise heard on inspiration, associated with inflammation, mucus, or fluid in the bronchioles
Term
Compliance
Definition
The stiffness or flexibility of the lung tissue
Term
Pulse Oximetry
Definition
A measurement of hemoglobin oxygen saturation in the peripheral tissues
Term
Oxygen Saturation Percentage (SpO2)
Definition
The saturation of arterial blood with oxygen as measured by pulse oximetry, expressed as a percentage. Normal 98% to 100%
Term
Mild Hypoxia
Definition
91-94%
Term
Moderate Hypoxia
Definition
86-91%
Term
Severe Hypoxia
Definition
85% or lower
Term
Capnography
Definition
A recording or display of the measurement of exhaled carbon dioxide concentraion
Term
Capnometry
Definition
Is the measurement of expired CO2. It typically provides a display of the partial pressure CO2 (in torr of mmHg) or percentage of CO2
Term
Capnograph
Definition
A capnograph a device that measures expired CO2
Term
Capnogram
Definition
Is a visual representation of the expired CO2 waveform
Term
End-Tidal CO2
Definition
Is the measurement of the CO2 concentration a the end of expiration
Term
PETCO2
Definition
Is the partial pressure of end-tidal CO2 in a mixed gas solution
Term
PaCO2
Definition
Represents the partial pressure CO2 in the arterial blood
Term
Normal ETCO2 levels
Definition
1 to 2 mm less than partial pressure or carbon dioxide, or approximately 5%
Term
Normal ETCO2
Definition
35-45
Term
4 phases of Capnogram
Definition
Phase 1: The respiratory baseline
Phase 2: The respiratory upstroke
Phase 3: The respiratory plateau
Phase 4: The inspiratory phase
Term
EDD
Definition
Endotracheal detector device, used to make sure that you have the ETT in trachea, CONTRAINDICATED in pediatric patients
Term
Jaw Thrust
Definition
Lift the jaw by grasping under the chin and behind the teeth, without tilting the head.
Term
Modified Jaw Thrust
Definition
Lift the jaw using fingers behind the mandibular angles; do not tilt head
Term
Nasopharyngeal Airway
Definition
Uncuffed tube that follows the natural curvature of the nasppharynx, passing through the noise and extending from the nostril to the posterior pharynx
Term
Nasopharyngeal Airway
Definition
Uncuffed tube that follows the natural curvature of the nasppharynx, passing through the noise and extending from the nostril to the posterior pharynx
Term
Nasopharyngeal Airway sizes
Definition
Range from 20-36 F
Term
French
Definition
Unit of measurement approximately equal to one-third millimeter
Term
Contraindications for nasopharyngeal airway
Definition
Patient's who are predisposed to nosebleeds, who have nasal obstructions, facial fracture, ICP?
Term
Oropharyngeal Airway
Definition
Semicircular device that follows the palate's curvature
Term
Contraindications for Oropharyngeal Airway
Definition
Patient's with a gag reflex, patients who are conscious or semi-conscious
Term
Oropharyngeal airway sizes
Definition
#0 to #6
Term
Endotracheal intubation equipment
Definition
Laryngoscope (handle, blade), ETT, 10-mL syringe, Stylet, BVM, Suction device, Magill forceps, Tape or tube-holding device
Term
Laryngoscope
Definition
Consists of handle and blade, used to move the tongue and the epiglottis out of the way so you can see the vocal cords
Term
White, tight and bright?
Definition
Test to make sure that your laryngoscope is ready to use
Term
ETT
Definition
Endotracheal Tube lengths range from 12 to 33 CM and end that you ventilate on 15mm inside diameter/22mm outside diameter
Internal sizes from 2.5 to 4.5 (uncuffed) to 5.0 to 9.0 (cuffed)
Term
Stylet
Definition
Plastic-covered metal wire used to bend the ETT into a J or hockey-stick shape for easier insertion
Term
Bougie
Definition
AKA Eschmann tracheal tube introducer. Is a straight semiriged stylet-like device with a bent end that is covered with a protective resin. It is used to facilitate ETT placement when intubation is anticipated to be difficult
Term
Magill Forceps
Definition
Are scissor-style clamps with circular tips.
Term
Endotracheal Intubation Indicators
Definition
*Respiratory of cardiac arrest
*Unconsciousness of obtusion without a gag reflex
*Risk of aspiraton
*Obstruction due to foreign bodies, trauma, burns,or anaphylaxis
*Respiratory extremis due to disease
*Pneeumothorax, hemothorax, or hemopneumothorax with respiratory difficulty
Term
Contraindications for Endotracheal intubation
Definition
Epiglottitis
Term
L.E.A.N.
Definition
Stand for the drugs that you can put down an ETT: Lidocaine, Epinephrine, Atropine, Naloxone
Term
Max amount of time to attempt Endotracheal Intubation at a time
Definition
30 seconds
Term
Insufflate
Definition
To blow into
Term
Tension Pneumothorax
Definition
Is marked by progressively worsening compliance (more difficulty in ventilation), diminished unilateral breath sounds, hypoxia with hypotension, and destended neck veins
Term
Ways to verify the placement of the ETT in the trachea
Definition
*Visualize the tube passing through the cords
*Presence of bilateral breath sounds
*Absence of breath sounds over the epigastrium
*Positive end-tidal CO2 change on an ETCO2 device
*Use of an EDD device
*Absence of vomitus in ETT
*Absence of phonation, or vocal sounds,once tube in place
Term
Transillummination Intubation
Definition
Uses a plastic cable with a malleable, retractable wire running through its center and a small, high density bulb on the distal end. Confirm correct placement by observing the stylet's light go through the anterior neck's soft tissue; esophageal intubation results when you do not see the light. This technique works best in the dark of in a thin patient.
Term
Digital Intubation
Definition
Uses your fingers to guide the tube into the trachea
Term
Rapid Sequence Intubation (RSI)
Definition
Giving medication to sedate (induce) and temporarily paralyze a patient and then performing orotracheal intubation.
Term
Rapid-sequence induction
Definition
Classic rapid sequence induction is an anesthetic procedure whereby patients rapidly receive induction of general anesthesia, followed by indotracheal intubation
Term
Acetylcholine
Definition
Is the primary neurotransmitter, and blocking it results in relaxation of skeletal muscle.
Term
Depolarizinig Agents
Definition
Substitute themselves into the neuromuscular junctions in place of acetylcholine
Term
Non-deplorizing agents
Definition
Block the uptake of acetylcholine and do not allow stimulation of the muscle
Term
Common Paralytic Agents
Definition
Succinylcholine, Vecuronium, Atacurium, Pancuronium
Term
Apnea
Definition
Temporary stop in breathing
Term
How to figure out pediatric ETT size
Definition
ETT size(mm) = (age in years + 16) / 4
Term
How to figure out depth of pediatric ETT placement
Definition
(3 x ETT diameter) - 1
Term
If heart rate falls below 60bpm (or below 80bpm in an infant) during endotracheal intubation
Definition
Stop the procedure and reinitiate ventilation with 100% oxygen
Term
Nasotracheal Intubation
Definition
Through the nose and into the trachea
Term
Indications for nasotracheal intubation
Definition
*Possible spinal injury
*Clenched teeth,preventing opening the patient's mouth (when RSI not available)
*Fractured jaw, oral injuries, or recent oral surgery
*Significant angioedema (facial and airway swelling)
*Obesity
*Arthritis, preventing placement in sniffing position
Term
Contraindication for nasotracheal intubation
Definition
*Suspected nasal fracture
*Significant deviated nasal septum
*Cardiac or respiratory arrest
*Unresponsive patient (b/c they have to exhale for you to be able to pass the tube)
Term
Esophageal Tracheal CombiTube
Definition
Is a dual-lumen airway with a ventilation port for each lumen.
Term
Pharyngo-Tracheal Lumen Airway
Definition
Is a two-tube system. The first tube is short, with a large diameter;it's proximal end is green.
Term
Laryngeal Mask Airway
Definition
Is an airway with an inflatable distal end that masks the laryngeal opening
Term
Esophageal Gastric Tube Airway and Esophageal Obturator Airway
Definition

Esophageal Gastric Tube Airway= is a hollow tube with a cuff to the proximal to the distal open port blocks air the esophagus.

Esophageal Obturator Airway=is a hollow tube with a closed end and a distal cuff intended to block air from the esophagus.

 

Term
Contraindications of the Esophageal Gastric Tube Airway and the Esophageal Obturator Airway
Definition

*Age less than 16

*Height less than 5 feet or more than 6'7"

*Possible ingestion of caustic poisons

*History or esophageal disease or alcoholism

Term
Needle Cricothyrotomy
Definition
Surgical airway technique that inserts a 14-gauge needle into the trachea at the cricothyroid membrane.
Term
Open Cricothyrotomy
Definition
Surgical airway technique that places an endotracheal or tracheostomy tube directly into the trachea through a surgical incision at the cricothyroid membrane
Term
Stenosis
Definition
Narrowing or constriction
Term
Barotrauma
Definition
Injury caused by pressure within an enclosed space
Term
Stoma
Definition
Opening in the anterior neck that connects the trachea with ambient air
Term
Suction
Definition
To remove with a vacuum-type device
Term
Oxygen tank sizes
Definition

(D) steel tank with 400-liters

(E) 660-liter

(M) 3,450-liter

Term
High pressure regulator
Definition
Regulator used to transfer oxygen at high pressures from tank to tank
Term
Therapy regulater
Definition
Pressure regulator used for delivering oxygen to patients
Term
Nasla cannula
Definition
Catheter placed at the nares delivers 40%
Term
Venturi Mask
Definition

High flow mask that uses a venturi system to deliver relatively precise oxygen concentrations

Delivers 24%,28%,40%

Term
Simple Face Mask
Definition
Provides 40-60%
Term
Nonrebreather Mask
Definition
Provides 80-93%
Term
Demand Valve Device
Definition
A ventilation device that is manually operated by a push button or lever
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