Term
| How long should direct laryngoscopy take? |
|
Definition
|
|
Term
| How many consecutive intubations might it take before you're exposed to common airway problems? |
|
Definition
|
|
Term
| Is it harder to learn to bag/mask ventilate or to intubate? |
|
Definition
|
|
Term
| 7 Steps before you intubate |
|
Definition
1-adequate airway eval. performed
2-checked airway equip.
3-suction is functional/at hand
4-patient is positioned correctly
5-All ASA monitors are on patient
6-Patient is apneic & unconscious
7-ability to bag/mask ventilate |
|
|
Term
| What size MAC blades are commonly used in adults? |
|
Definition
|
|
Term
| What size miller blades are commonly used in adults? |
|
Definition
|
|
Term
| ET tube sizes for males and females |
|
Definition
males: 7.5-8
females: 7-7.5 |
|
|
Term
|
Definition
| 9, 10, & 11cm. Keep 10cm one out. |
|
|
Term
|
Definition
28-34 french
can leave in drawer, just need to know you have them
have KY jelly for these too |
|
|
Term
|
Definition
3-5 for adults
just know you have them in case you need them |
|
|
Term
|
Definition
check it every day
must be IN ROOM with you |
|
|
Term
|
Definition
must have IN ROOM
check everyday |
|
|
Term
| Suction during intubation |
|
Definition
should be within reach
yankauer tip should be on
check it between cases |
|
|
Term
|
Definition
patients head all the way at end of bed
patient centered on bed
bed level with AA's bellybutton |
|
|
Term
|
Definition
aligns oral, pharyngeal, and laryngeal axes
combines A/O extension with cervical flexion |
|
|
Term
| How much pillow is needed to achieve sniffing position? |
|
Definition
|
|
Term
| Sniffing position considerations with morbidly obese people |
|
Definition
fat pad at base of neck limits A/O extension
"ramp" up bed using sheets/blankets |
|
|
Term
| How long and until what FeO2 do we preoxygenate? |
|
Definition
3-5 minutes (deeper breaths speeds it up)
FeO2 of 90% or greater |
|
|
Term
|
Definition
|
|
Term
| Intubating dose of rocuronium |
|
Definition
|
|
Term
|
Definition
| brushing eyelashes and looking for a lack of response to ensure adequate sedation |
|
|
Term
|
Definition
good for beginners
but takes up couple mm of viewing space |
|
|
Term
| How do you use the laryngoscope blade while intubating? |
|
Definition
| Insert blade on right side, sweep tongue to the left |
|
|
Term
| what structures impede our view of the glottic opening? |
|
Definition
tongue
floor of mouth
epiglottis
mandible |
|
|
Term
| Where does the tip of the mac blade sit and how does aid in revealing the glottic structure to us? |
|
Definition
the tip sits in the vallecula
it tenses the hyoepiglottic ligament to lift the epiglottis out of the way anteriorly |
|
|
Term
| Where does the tip of the miller blade sit? |
|
Definition
| put blade in deep so it hits epiglottis and pins it against laryngeal wall |
|
|
Term
| BURP (to improve your view of the glottic opening) |
|
Definition
|
|
Term
| When do we place the et tube? |
|
Definition
| when glottic opening visualization is optimal |
|
|
Term
|
Definition
slide it 2-3cm further after you see it go through glottis
optimal positioning is 2-4cm above corina |
|
|
Term
| common intubation mistakes |
|
Definition
inserting curved blade too deep
tongue not out of the way
blade tip isn't medial |
|
|
Term
| What do you do after the ET tube is in? |
|
Definition
| hold it with your left hand, inflate the cuff, confirm tube is in trachea via ETCO2 and bilateral breath sounds, and secure tube |
|
|
Term
|
Definition
minimum airway occlusion pressure
usually about 22-23 cmH2O (or 5-6mL of air injected into cuff) |
|
|
Term
|
Definition
| measurement of CO2 during respiratory cycle |
|
|
Term
|
Definition
most common
CO2 waveforms displayed on screen |
|
|
Term
| End tidal carbon dioxide detector |
|
Definition
color change device (purple to yellow when exposed to CO2)
cheap, simple, disposable |
|
|
Term
| Can CO2 be found in stomach? |
|
Definition
yes, from gas entering during mask ventilation
but waveforms don't look normal |
|
|
Term
| Negative Pressure devices |
|
Definition
aspiration of tube when in trachea results in reinflation of the device
aspiration of tube in esophagus results in walls collapsing and no inflation of bulb |
|
|
Term
| Auscultation to determine tube placement |
|
Definition
confirms correct positioning of ET tube
done right after intubation |
|
|
Term
| Fiberoptic bronchoscope to determine tube placement |
|
Definition
gold standard
expensive & impractical
always used for double lumen tube placement |
|
|
Term
| Pulse oximeter with regards to tube placement |
|
Definition
| Does NOT confirm tube placement |
|
|
Term
|
Definition
| usually enters right mainstem bronchus |
|
|
Term
| Minimum check to confirm tube placement |
|
Definition
| auscultate and confirm CO2 concentration >4% or perform neg. pressure test |
|
|
Term
|
Definition
tape to bony structures of maxilla
or wire around a tooth for plastic surgeries |
|
|
Term
|
Definition
used in an effort to prevent patient from biting down and occluding tube
rolled up gauze or oral airways work well |
|
|
Term
| Problems with nasotracheal intubation |
|
Definition
takes longer
increased chance of bleeding |
|
|
Term
|
Definition
| 1/2 size smaller than normal ET tube |
|
|
Term
|
Definition
soak in warm,sterile saline
lube tip |
|
|
Term
|
Definition
| 3 cm greater than ET tube |
|
|
Term
| When is blind nasotracheal intubation used? |
|
Definition
in elective patients
when direct visualization is tough
--jaw wired shut |
|
|
Term
|
Definition
|
|
Term
|
Definition
applied during RSI
distorts airway view
may increase aspiration risk |
|
|
