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Advanced Airway Management Flashcards

(58 cards)

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1
Q

Laryngeal Structures

A

Hyoid Bone
Thyrohyoid Membrane
Thyroid Cartilage
Cricothyroid Ligament
Cricoid Cartilage
Trachea

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2
Q

Pharyngeal tonsil

A

Adenoids

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3
Q

Epiglottis

A

Flap of elastic cartilage tissue
Guards entrance of the glottis, opening between vocal cords

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4
Q

Vocal Cords

A

Twin in-foldings of mucous membranes stretched across the larynx

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5
Q

CATHE

A

Inferior to superior of larynx

Cricoid cartilage
Arytenoid Cartilage
Thyroid Cartilage
Hyoid Bone
Epiglottis

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6
Q

Innervation of Larynx

A

Vagus Nerve

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7
Q

Vagus Nerve Stimulation

A

Decreases HR, BP, RR
Risk of stimulation with intubation/overinflation of king LT

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8
Q

Indications King LT

A

Need for ventilatory assistance/airway control

Other airways ineffective

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9
Q

Conditions King LT

A

GCS 3 w/o gag reflex

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10
Q

Contraindications King LT

A

Active vomiting
Inability to clear airway
Airway edema
Stridor
Caustic Ingestion

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11
Q

Medications which can go down King LT

A

Ventolin

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12
Q

Advantages of LMA

A

Minimal soft tissue trauma
Lower tidal volumes
Decreased gastric insufflation
Unaffected anatomical factors
Less coughing and laryngospasm
Decreased sympathetic response
Better tolerated

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13
Q

Disadvantages of LMA

A

No protection for aspiration/bleeding
Mouth required to be opened >0.6”
Difficult to adequately ventilate if needing high airway pressure
Not effective if airway anatomy abnormal

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14
Q

Contraindications of King LT

A

Risk of aspiration
High airway resistance
Presence of tumours, abscess, hematoma

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15
Q

Considerations for ETT

A

Failure to protect airway, failure of ventilation/oxygenation

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16
Q

Indications for ETT

A

Need for ventilatory assistance or airway control, other airways ineffective

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17
Q

LEMON

A

Look Externally
Evaluate 3-3-2
Mallampati
Obstruction
Neck Mobility

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18
Q

Look Externally

A

Beard
Moustache
Abnormal facial shape
Facial disruption by trauma
buck teeth
Obesity
Craniofacial abnormality
Neck mass
Large tongue
Trauma

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19
Q

3-3-2 Rule

A

3 Fingers between teeth
3 fingers from mentum to hyoid
2 fingers between hyoid and thyroid notch

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20
Q

Mallampati 1

A

Uvula, soft palate, faucial pillars visible

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21
Q

Mallampati 2

A

Uvula partially blocked by tongue, soft palate + faucial pillars visible

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22
Q

Mallampati 3

A

Soft palate visible, base of uvula may be visible, no other structures visible

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23
Q

Mallampati 4

A

Hard palate only visible

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24
Q

Obstruction

Study These Flashcards
A

Laryngeal tumour
Evidence of airway obstruction
Epiglottitis
Peritonsillar abscess
Foreign body
Airway trauma
Noisy breathing
Inflammation

25
Neck Mobility
Reduced in elderly, arthritis, immobilization
26
BONES
BVM assessment Beard Obese No teeth Elderly Snores
27
MOANS
BVM assessment Mask seal Obesity Age No teeth Stiff
28
SLOPES
Suction, stylet Laryngoscope, lube, lidocaine Oxygen, OPA, Otrivin Pillow/Positioning ETT/ETCO2 Stethoscope, syringe, securing device
29
ETT tube sizing children
Age/4 + 4
30
ETT Depth to teeth child >2
Age/2 + 12
31
ETT Depth
Tube size x 3
32
Cormack and Lehane Scale
Grade 1: Full view Grade 2: Epiglottis and arytenoids only Grade 3: Epiglottis only Grade 4: cannot see epiglottis
33
Sellick's Maneuver
Protect from regurgitation/aspiration 10lbs pressure Release if vomiting occurs to prevent esophageal rupture Maintain until cuff inflated Controversial if effective
34
Awake Intubation
GCS <8 Lidocaine 10mg/spray Max 5mg/kg to 20 sprays
35
Confirmation of ETT Placement
ETCO2 Visualization Auscultation Chest rise Misting Syringe aspiration SpO2
36
ETT Attempt
Insertion of laryngoscope for purpose of intubation
37
ETT Need For Sedation
Monitor HR and BP Gagging ETCO2
38
Indications for Procedural Sedation
Post-intubation, transcutaneous pacing
39
Conditions Procedural Sedation
>18 RR >10 (non-intubated) Normotension
40
Treatment Procedural Sedation
Midazolam 2.5-5mg Max 5mg/dose Total 10mg 2 doses 5 min apart
41
ETT Complications
Esophageal intubation Vomiting Aspiration Right mainstream intubation Inability to intubate Loss of adaptor Torn cuff Dysrhythmias Laryngospasm Increased ICP Hypoxia Trauma Flooded airway
42
Trouble Shooting ETT Compliance
DOPE BP Displacement Obstruction Pneumothorax Equipment Bronchospasm Pulmonary Edema
43
Esophageal obstruction
Treat with 1.0mg glucagon IV
44
Laryngospasm
Involuntary closure of glottic opening resulting in partial or complete airway obstruction
45
Causes of Laryngospasm
Extubation Intubation/airway manipulation ENT procedures Fluids Foreign body Aspiration Reflux Near drowning
46
Larson's Point
Laryngospasm notch Break laryngospasm by applying painful anterior pressure at larson's point bilaterally while performing jaw thrust
47
Indications Digital Intubation
Trauma Obese or short necked pts Secretions or bleeding obscures visualization
48
Pros of Digital Intubation
Fast No requirement for positioning Minimal C-spine movements for trauma pts Ideal for those predicted to be difficulty airways Used for copious secretions/blood and cannot visualize
49
Cons of Digital Intubation
Requires training Being bit by pt Airway trauma Pt must be paralyzed or comatose/dead Benefits those with long, slender fingers
50
Pickaxe/Tomahawk method
For trauma scenarios In awkward situation
51
Times for Blind nasal intubation
C-spine injury Airway control in conscious pt Trismus Significant head injury
52
Advantages nasal intubation
Better tolerated No laryngoscope Easier positioning Awake pt Pt cannot bite tube or manipulate with tongue
53
Disadvantages nasal intubation
Increased airway pressure Limited compatibility Epistaxis Vocal cord trauma Infection
54
Contraindications Nasal Intubation
<50 and asthma exacerbation not in or near cardiac arrest Basal skull fracture Uncontrolled epistaxis Bleeding disorders
55
Complications of nasal intubation
Epistaxis Damage to nasal cavity Aspiration Vagal stimulation Laryngospasm Vocal cord damage
56
Reasons for Tracheostomy
Bypass obstruction Remove secretions Oxygen delivery Trauma/airway complications
57
Cricothyrotomy
Emergency airway procedure Between cricoid and thyroid cartilages through the cricothyroid membrane
58
DOPES trach emergency
Displacement of tube Obstruction of tube Patient Equipment Stacked breaths

Patient Care (11 decks)

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