airway management Flashcards by Kacie Brien

When was the anesthesia face mask invented and with what material?

1917
silicone or rubber

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what are 3 things to be careful with when masking a patient?

do not compress the facial nerve or artery
do not put pressure on patients lips
do no put pressure on patient’s eyes

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if a patient has no teeth, you may need to include ____ in the mask

chin

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why do we use clear masks now?

allows for visualization of the patient’s mouth to look for vomitus, blood, secretions, condensation, and lip color

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describe early face masks

they were made of black rubber and reusable

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what are the key elements to mask technique

maintain a seal between mask and patient’s face
upper airway is unobstructed
one-handed ventilation

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name the signs of effective ventilation

chest rise and fall
capnography
exhaled tidal volume
condensation in the mask
pulse ox

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why do we tape the eyes?

to avoid corneal abrasions

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during mask ventilation, peak inspiratory pressured need to be ________

no greater than 20 cm H20

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why do we want peak inspiratory pressures 20 or less during mask ventilation?

to help prevent gastric insufflation during positive pressure ventilation

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how to correct airway obstruction during mask ventilation?

atlantoocciptal extension
jaw thrust

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as induction agents start to work, airway muscle tone will relax. tissue relaxes and can fall back and ____ the airway

obstruct

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this position allows for alignment of the oral and pharyngeal axes

sniffing position

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if there is neck injury or disease, the head must remain in the _____ position

neutral

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____ is the volume of a breath that does not participate in gas exchange

dead space

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what is ventilation without perfusion called?

dead space

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physiologic or total dead space is the sum of ____ and ____

anatomic dead space and alveolar dead space

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the volume of gas within the conducting zone and includes the trachea, bronchus, bronchioles, and terminal bronchioles

anatomic dead space

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anatomic dead space is approximately ____ ml/kg in the upright position

2 mL/kg

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the volume of gas within unperfused alveoli

alveolar dead space

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what is the ratio of physiologic dead space to tidal volume?

1:3

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why would you use a mask head strap?

if the clinician has small hands
patient has a beard
patient aint got no teef

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what is a nasal mask typically used for?

anesthesia by dentists

it has an APL

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name all the ways a procedural oxygen mask (POM) can be utilized as a universal multi-function device:

theres like 6

Upper endoscopies
conscious sedation
nasal bronchs
TEE
PEG
fiberoptic intubations

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what does the catheter mount connect the breathing circuit to?

tracheostomy supraglottic airway ETT face masks

does a catheter mount have corrugated tubing?

yes sir

name the type of mask: has a resevoir provides a higher FiO2 one way valve betweent the bag and mask to prevent rebreathing

partial rebreathing mask

oxygen via a nasal cannula and face masks are considered ___ oxygen

open

you want to decrease the FiO2 to ____ during times of bovie use to decrease fire risk when there is open oxygen

30%

what FiO2 and liters can a nasal cannula provide

28-36% says don't go above 2-4L /min

fixed high performance device high air flow oxygen enrichment delivers a fixed and predetermined concentration of oxygen

venturi mask

give me the formula for Bernoli's Principle

P + 1/2 pv squared = K | k= density, v= velocity, p=pressure

name me some predictors of a difficult mask ventilation

OSA/snoring 55+ male BMI 30+ Mallampati 3 or 4 beard edentulous

oral and nasal airways work to keep open the space between the ____ and the ____

tongue and the posterior pharyngeal wall

how do you size an oral ariway

measure from corner of the mouth to earlobe

T/F awake patients can get oral airways?

FALSE

improper sized oral airways can cause what two damages?

lingual nerve palsy or tooth damage

where do nasal airways sit?

from the nose to just above epiglottis

how do you measure a nasal airway?

measured from the meatus of ear to the nares

T/F: oral airways are longer than nasal airways?

FALSE, nasal airways are 2-4 cm longer than oral airways

what patients do you wannna be cautious with nasal airways with?

thrombocytopenia or those on anticoags

name this enhanced airway

McMurray | used for EGD or MAC cases

what kind of cases is the Oberto Mouth Prop used for? | not a penis

it is a hard bite block used for electroconvulsive therapy (ECT)

what is a tooth guard used for?

used during intubation to protect the patients teeth | maybe kids but theyre wayy too small for adults

name this airway and what its used for

Berman Intubating Airway used during fiberoptic intubation it is split so that it can be removed once ETT is in place

what is the standard oral airway called

guedel airway

directs airflow to the glottis, the treachea, and the lungs

A supraglottic airway device

what is a SGA used for?

ventilated patients spontaneous breathing patients

is a supraglottic airway a rescue device?

yes it can be used when unable to intubate or unable to ventilate

is an LMA a secure airway?

no way jose

Since the ETT, what is thought to be the greatest advancement in airway management?

the LMA

how are LMAs sized?

by kilogram weight

name the steps to ensure successful LMA insertion: | like 6 of them

pick the right size position patient in sniffing position LUBE IT they must be adequately anesthesetized use index finger to guide it do not deflate cuff or remove until patient is awake and opens their mouth

T/F, you hold onto the LMA when youre inflating the cuff?

no let that shit go it wont create a good seal if you hold it

name some complications that can occur from an LMA

pharyngeal necrosis uvula trauma nerve damage vocal cord paralysis

what nerves can be damaged from an LMA insertion?

lingual nerve recurrent laryngeal nerve hypoglossal nerve

name some contraindications of an LMA insertion

full stomach, pregnant, hiatal hernia, trauma pulmonary disease (restrictive disease)

what % of people get a sore throat after an LMA

10-20%

what are 3 major concerns when using LMA

risk of aspiration risk of regurgitation risk of gastric inflation

who invented the LMA Classic

Dr Archie Brain

what was the original LMA, reusable up to 40 times, and used for neonates to adult

LMA Classic

used in neonates to adults has 7 sizes has aperature bars part of the ASA Diff airway algorithm

LMA Unique | disposable

used when the airway needs to be shared airway tube can be moved side to side ability to move patients head from side to side

LMA Flexible | children getting tonsils out and adenoids

what LMA protects the airway from blood accumulation above the airway?

LMA Flexible

used for difficult ariways or during CPR size 3,4,5 intubating LMA used in ER, prehospital, crash carts

LMA Fastrach

name this

Fastrach LMA

a resuable LMA port fro gastric access gastric contents bypass the pharynx decreases aspiration risk

LMA Proseal

what are soem characteristic differences of the LMA Proseal?

larger bowl gastric drainage tube spot for index finger for insertion silicon bite block

what LMA can provide positive pressure ventilation up to 30 mmH20?

LMA Proseal

name this LMA

Proseal LMA

what LMA is the same as the proseal bu thas a reinforced bite block?

the LMA Supreme

name the advantages of an LMA ## Footnote like 6

better seal in patients with facial hair hands are free to do other tasks better able to maintain a patent airway decreased injury to eyes or facial nerves decreased OR Pollution decreased airway secretions

name some disadvantages to LMA | like 5

risk of airway trauma more invasive airway deeper level of anesthesia is required diffusion of N20 thru the cuff contraindicated in some cases

name the cases that are contraindicated for LMA use

laparoscopic cases obese peeps pregnant mamas prone gases | y

what has more risk for laryngospams? LMA or ETT

ETT

this LMA is single use, no need for cuff inflation, lessens risk of injury from compression or displacement trauma

i-Gel

name the structures in the mouth