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Year 4 POEM > Airway management > Flashcards

Airway management Flashcards

1
Q

Describe anatomy of upper airway

A
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2
Q

signs: obstructed airway

A

paradoxical chest/abdo movements
cyanosis
stridor
curgling
accessory muscles

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3
Q

signs: partial v complete airway obstruction

A

LOOK: paradoxical chest/abdo movemenets and cyanosed v no movement
LISTEN: noisy breathing (stridor, snoring) v silent
FEEL: some air movement v no air movement

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4
Q

cause: collapsed airway in unconscious patient

A

loss of airwat muscle tone

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5
Q

causes: upper airway obstruction

A
  • CNS depression
  • foreign body aspiration
  • infection (epiglottitis, tracheitis, croup etc)
  • haemorrhage/haematoma
  • trauma
  • burns
  • neoplasm
  • congenital
  • NMD
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6
Q

resus uk choking guideline

A
  • mild with effective cough - encourage cough and check for deterioration to ineffective cough or obstruction relieved
  • severe and conscious = 5 back blow and 5 abdominal thrusts
  • sever and unconscious = start CPR
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7
Q

steps to open airway

A
  1. head tilt, chin lift
  2. jaw thrust
  3. nasopharyngeal airway if semi-unconscious
  4. oropharyngeal if unconscious
  5. supraglottic device/LMA
  6. ET tube
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8
Q

contraindications: oropharyngeal airway adj

A

conscious with gag reflex in tact
stimulates vomiting which can further obstruct airway

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9
Q

contraindications: nasopharyngeal airway adj

A

base of skull #
trauma to nose (eipstaxis etc)

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10
Q

measure oropharyngeal airway adj

A

inscisor teeth to angle of mandible

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11
Q

measure nasopharyngeal aiwary adj

A

tip of patient’s nose to earlobe

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12
Q

adv: LMA over ET

A
  • quicker insertion
  • easier insertion
  • less CVS stimulation
  • lower frequency of cough reflex on insertion
  • lower incidence sore throat
  • can be used outside of operating theatre - more user friendly
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13
Q

diadv: LMA over ET

A
  • not secure - higher risk of aspirating
  • gastric insufflation more likely
  • can cause laryngospasm
  • air leak
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14
Q

contraindications: LMA

A

non-fasted patient
severe GORD
morbidly obese
pregnancy
obstructive/abnormal lesions in oropharynx
increased airway resistance and decreased lung complicance

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15
Q

check: igel in correct position

A
  1. teeth resting on bite block (incisors)
  2. tip of igel in upper oesophageal opening
  3. cuff located against laryngeal framework in hypopharynx
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16
Q

placement of ET tubes anatomically

A

transverses airway via oropharynx or nasopharynx and passes through vocal cords to sit in trachea abovew carina

adv

16
Q

placement of ET tubes anatomically

A

transverses airway via oropharynx or nasopharynx and passes through vocal cords to sit in trachea abovew carina

16
Q

placement of ET tubes anatomically

A

transverses airway via oropharynx or nasopharynx and passes through vocal cords to sit in trachea above carina

adv

17
Q

adv: ET tube

A
  • transverses airway via oropharynx or nasopharynx and passes through vocal cords to sit in trachea abovew carinaprotects from aspiration
  • provides access to tracheo-bronchial tree for suctioning secretions
  • does not cause gastric distension and associated risk of regurgitation
  • maintains patent airway and assists in avoiding further obstruction

adv

18
Q

complications: ET tube

A
  • oesophageal intubation
  • endobronchial intubation (inserted past carina into one main bronchus so other lung not ventilated)
  • impaction (ET tip against tracheal wall causes obstruction)
  • herniation (cuff can cover distal end of tube if overinflated)
  • stretching of tracheal wall (?necrosis)
  • must be trained (anaesthetist) to place
19
Q

signs: oesophageal ET intubation

A
  • large air leak following cuff inflation
  • no capnography after inflation breaths
  • hypoxia
20
Q

signs: endobronchial ET intubation

A
  • hypoxia
  • bronchospasm
  • high airway inflation pressures
21
Q

what permits air to flow in ET tube despite impaction

A

Murphy’s eye

22
Q

def: Bougie

A
  • long thin device used for routine or difficult intubation when laryngeal inlet not fully visualised
  • can be used as introducer for ETT placement - tracheal clicks as introduced below vocal cords and then hold up - not hold up = ?oesophagus
23
Q

def: Magill’s forceps

A

guide tracheal tubes through vocal cords or nasogastric tubes into oesophagus under direct vision

Year 4 POEM (9 decks)

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