Supraglottic + Croup Flashcards

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1
Q

Supraglotic Airway Medical Directive

What are the INDICATIONS?

A

Need for ventilatory assistance or airway management
AND
Other airway management is ineffective

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2
Q

Supraglotic Airway Medical Directive

What are the CONDITIONS?

What are the CONTRAINDICATIONS?

A

Absent gag reflex

Airway obstructed by a foreign object

Known Esophageal dieases (verices)

Trauma to the oropharynx

Caustic ingestion

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3
Q

Supraglotic Airway Medical Directive

What is the TREATMENT plan?

A

Considering supraglotic airway insertion of 2 attempts max (per patient)

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4
Q

Supraglotic Airway Medical Directive

What are the primary and secondary methods of determining proper placement?

A

Primary:
ETCO2 (Waveform Capnography)

Secondary:
ETCO2 (Non-waveform device)
Auscultation
Chest Rise

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5
Q

Supraglotic Airway Medical Directive

What is an attempt defined as

If ETCO2 is working is that good enough, if it isn’t working, what do you do?

A

An attempt is defind as insertion of the supraglotic airway into the mouth.

Yes ETCO2 is good enough
You’d need 2 secondary methods for confirmation

Yes, if not then you have to use 2 secondary methods to confirm

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6
Q

Croup Medical Directive

What are the INDICATIONS?

A

Current hx of URTI (upper respiratory tract infection)
AND
Barking cough or recent hx of a barking a barking cough

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7
Q

Croup Medical Directive

What are the CONDITIONS for Epinephrine?

What are the CONTRAINDICATIONS?

A

Pt has to be GREATER/EQUAL to 6 months old and LESS than 8 years old
AND
Pt’s HR has to be LESS than 200bpm
AND
Pt has stridor at rest

Allergy or sensitivty

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8
Q

Croup Medical Directive

What are the CONDITIONS for dextamethasone?

What are the CONTRAINDICATIONS?

A

Pt has to be GREATER/EQUAL to 6 months old and LESS than 8 years old

AND

Pt’s LOA has to be unaltered
AND

The pt has to have mild, moderate, or severe croup

Allergy or sensitivity
The pt’s received steroids within the last 48 hours
The pt is unable to tolerate oral medications

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9
Q

Croup Medical Directive

What is the TREATMENT plan, CONCENTRATION, AND route for epinephrine a pt weighing LESS than 10kg?

A

1:1000
NEB

Dose - 2.5mg

Max.single dose - 2.5mg

Dosing Interval - no interval

Max # of doses - 1

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10
Q

Croup Medical Directive

What is the TREATMENT plan, CONCENTRATION, AND route for epinephrine in a pt weighing GREATER/EQUAL than 10kg?

A

1:1000
NEB

Dose - 5.0mg

Max.single dose - 5.0mg

Dosing Interval - no interval

Max # of doses - 1

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11
Q

Croup Medical Directive

What is the TREATMENT paln AND ROUTE for dexamethasone?

A

ROUTE - PO ONLY

Dose - 0.5mg/kg

Max.single dose - 8mg

Dosing Interval - no interval

Max # of doses - 1

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12
Q

Croup Medical Directive

What is croup?

A

A virus that causes an upper (usually) airway infection in children.

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13
Q

Croup Medical Directive

What is stridor, what part of the airway is compromised?

Why is 48 hours an important contraindication for dex?

Why is a HR LESS than 200bpm an improtant condition?

A

The narrowing of the upper airway more likely near the layrnx, vocal cords, susurroundings

If it’s already in your system additional dose won’t improve (half-life)

Becuase if they’re over 200bpm then it will decrease the hearts ability to perfuse blood (over 200bpm = poor perfusion

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14
Q

Croup Medical Directive

When treating with dexamethasone, the contraindication to steroids applies to?

What is the minial initial volume for NEB?

How do administer epi via NEB

A

PO AND Parenteral
NOT inhaled or topical

2.5mL

Add saline

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15
Q

Croup Medical Directive

What medication is priority?

What do you give for mild-moderate presentation of croup?

What sould you do when/before NEBing the pt with epinephrine?

A

Epi

ONLY give dex

Moistening/cool the air if available and the pt’s condition permits

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16
Q

Croup Medical Directive

What do you do if you see croup in adults?

A

If the indications are met, then patch to BHP

17
Q

Supraglotic Airway Medical Directive

What is esophageal disease AND why is it important?

A

Esophageal varices are enlarged veins in the esophagus. They’re often due to blocked blood flow through the portal vein.
Important because it impedes application of SGA

18
Q

Supraglotic Airway Medical Directive

When should you consider withholding the SGA?

Does anything change the withholding status?

A

If the patient is actively vomitting (ongoing vomitting - unable to clear the airway)

Consider inserting the SGA if you’ve cleared the airway of vomit

19
Q

Supraglotic Airway Medical Directive

How do you identify the need for ventilatory assistance?

What other airway management do we use?

A

Subjected assessment of the pt’s respiratory status

OPA
King LT
LMA
IGel

NPA

20
Q

Supraglotic Airway Medical Directive

Capnography to know

A
21
Q

Supraglotic Airway Medical Directive

Types of supraglottic airway

A