Airway Management - Opening, Suctioning, Adjuncts, & Maintaining

Question 1

To most effectively open the airway and assess breathing, the unresponsive patient should be in the ___ position

Answer 1

Supine

Question 2

If a situation delays placement in the supine position, the patient’s airway must be ___

Answer 2

Opened and assessed in the position in which the patient is found

Question 3

If a patient is found in the prone position, they must be ___

Answer 3

Repositioned to allow for the assessment of airway and breathing and to begin CPR

Question 4

When rolling a patient with a suspected spine injury, who calls out the count?

Answer 4

The person controlling the head

Question 5

Maneuver to open the airway in a patient without a suspected cervical spine injury

Answer 5

Head tilt-chin lift maneuver

Question 6

Do not use your ___ to lift the chin

Answer 6

Thumb

Question 7

The completed jaw-thrust maneuver should open the airway with the mouth ___

Answer 7

Slightly open and the jaw jutting forward

Question 8

Patients with a history of rheumatoid arthritis or Down syndrome are predisposed to ___

Answer 8

Instability of the cervical spine, specifically at the 1st and 2nd cervical vertebrae

Question 9

Regular chest wall movement indicates ___

Answer 9

A respiratory effort is present

Question 10

How to open a patients mouth while conducting airway maneuver

Answer 10

Place the tips of the index finger and thumb in the patient’s teeth. Push the thumb on the lower teeth and index finger on the upper teeth. Called the cross-finger technique

Question 11

If the airway is not clear, you will force the fluids and secretions ___

Answer 11

Into the lungs, resulting in aspiration

Question 12

After the airway, the next priority is ___

Answer 12

Suctioning

Question 13

If you hear gurgling, ___

Answer 13

The patient needs suctioning

Question 14

A fixed suctioning unit should generate a vacuum of more than ___

Answer 14

300 mm/Hg

Question 15

Plastic, rigid pharyngeal suction tips

Answer 15

Tonsil tips (Yankauer tips or DuCanto catheter)

Question 16

Nonrigid plastic catheters

Answer 16

French or whistle-tip catheters

Question 17

Suctioning unit should be fitted with ___

Answer 17

1. Wide-bore, thick-walled, non kinking tubing
2. Tonsil tips
3. Nonrigid plastic catheters
4. Nonbreakable, disposable collection bottle
5. Water for rinsing the tips

Question 18

Hollow, cylindrical device that is used to remove the fluids from the patient’s airway

Answer 18

Suction catheter

Question 19

A ___ is the best type of catheter for infants and children

Answer 19

Tonsil-tip catheter

Question 20

Tips with a curved contour allow for ___

Answer 20

Easy, rapid placement in the oropharynx

Question 21

___ are used to suction the nose and thin secretions in the back of the mouth, and in situations in which you cannot use a rigid catheter

Answer 21

French or whistle-tip catheters

Question 22

An opening through the skin that goes into an organ or other structure

Answer 22

Stoma

Question 23

What kind of catheter cannot be used in a patient with a stoma?

Answer 23

Rigid catheter

Question 24

When measuring for a catheter, use the same techniques as when measuring for an ___

Answer 24

Oropharyngeal airway

Question 25

Don't touch the back of the airway with a suction catheter because it can ___

Answer 25

Stimulate the gag reflex

Question 26

Aggressive suctioning can also stimulate the ___ and cause ___, especially in ___

Answer 26

1. Vagus nerve 2. Bradycardia 3. Infants and small children

Question 27

Aspiration increases the risk of mortality by ___

Answer 27

30% to 70%

Question 28

Between suction attempts ___

Answer 28

Rinse the catheter and tubing with water to prevent clogging with dried vomitus or other secretions

Question 29

When suctioning a conscious or semiconscious patient ___

Answer 29

Use extreme caution and put the tip in only as far as you can visualize

Question 30

How to measure the catheter?

Answer 30

Measure from the corner of the mouth to the earlobe or angle of the jaw

Question 31

Do not suction while ___

Answer 31

Inserting the catheter

Question 32

When suctioning, turn the patient's head ___, unless ___

Answer 32

1. To the side 2. You suspect a cervical spine injury

Question 33

Apply suction in a ___ motion as you ___

Answer 33

1. Circular motion 2. Withdraw the catheter

Question 34

If an obstruction is in a patient's mouth that cannot be suctioned out ___

Answer 34

Log roll them to the side and carefully clear the mouth

Question 35

Only attempt to remove an object from the mouth if it is ___

Answer 35

Visible

Question 36

If a patient requires assisted ventilations is producing frothy secretions as quickly as you can remove them ___

Answer 36

Alternate suctioning with ventilations

Question 37

The primary function of an airway adjunct

Answer 37

Prevent obstruction of the upper airway by the tongue and allow the passage of air and oxygen to the lungs

Question 38

Two principle purposes of an oropharyngeal airway

Answer 38

1. Keep the tongue from blocking the upper airway 2. Make it easier to suction the oropharynx if necessary

Question 39

How to suction with an oropharyngeal airway

Answer 39

Through an opening down the center or along either side of the airway

Question 40

Indications for the oral airway

Answer 40

1. Unresponsive patients without a gag reflex (breathing or apneic) 2. Any apneic patient being ventilated with a bag-mask device

Question 41

Contraindications for the oral airway

Answer 41

1. Conscious patients 2. Any patient who has an intact gag reflex

Question 42

Protective reflex mechanism that prevents food and other particles from entering the airway

Answer 42

Gag reflex

Question 43

If the patient gags while you are attempting to insert an oral airway ___

Answer 43

Immediately remove the adjunct and prepare to log roll the patient and suction the oropharynx, should vomiting occur

Question 44

An oral airway is a safe way to maintain an airway of a patient with a possible ___

Answer 44

Spinal injury

Question 45

An oral airway does not replace ___

Answer 45

Manual maneuvers

Question 46

If the oral airway is too large ___

Answer 46

It could push the tongue back into the pharynx, blocking the airway

Question 47

If the oral airway is too small ___

Answer 47

It could block the airway directly like any foreign body obstruction

Question 48

How to measure for oral airway

Answer 48

Measure for the earlobe or angle of the jaw to the corner of the mouth

Question 49

How to insert oral airway

Answer 49

Insert upside down and then rotate 180º

Question 50

The flange of the oral airway should rest ___

Answer 50

Against the lips or teeth

Question 51

In children, the only acceptable method of inserting an oral airway is to ___

Answer 51

Use a tongue blade to hold the tongue down while inserting the airway. Rotating it in the posterior pharynx may cause damage

Question 52

If you encounter difficulty while inserting the oral airway, ___

Answer 52

Insert the airway with a 90º rotation

Question 53

When inserting an oral airway with a 90º rotation

Answer 53

Use a bite stick or tongue depressor to depress the tongue, rusting it remains forward

Question 54

If a patient becomes responsive and regains the gag reflex after an oral airway is inserted ___

Answer 54

Gently remove the airway by pulling it out, following the normal curvature of the mouth

Question 55

Usually used with an unresponsive patient or a patient with an altered LOC who has an intact gag reflex and is not able to maintain their airway spontaneously

Answer 55

Nasopharyngeal airway

Question 56

Coat the nasal airway with ___

Answer 56

Water-soluble lubricant

Question 57

Indications for the nasopharyngeal airway

Answer 57

1. Semiconscious or unconscious patients with an intact gag reflex 2. Patients who otherwise will not tolerate an oral airway

Question 58

Contraindications for the nasal airway

Answer 58

1. Severe head injury with blood draining from the nose 2. History of fractured nasal bone

Question 59

How to measure for a nasal airway

Answer 59

Measure from the tip of the nose to the earlobe

Question 60

Which nostril should the nasal airway be placed?

Answer 60

The larger one

Question 61

With a nasal airway, if using the right nare, ___

Answer 61

The bevel should face the septum

Question 62

With a nasal airway, if using the left nare, ___

Answer 62

1. Insert the airway with the tip of the airway pointing upward, which will allow the bevel to face the septum 2. Insert until resistance is met and rotate 180º

Question 63

The curvature of the nasal airway should follow ___

Answer 63

The curve of the floor of the nose

Question 64

When the nasal airway is inserted completely ___

Answer 64

The flange rests against the nostril. The other end opens into the posterior pharynx

Question 65

Used to help maintain a clear airway in an unconscious patient who is not injured and is breathing on their own with a normal respiratory rate and adequate tidal volume

Answer 65

Recovery position

Question 66

The recovery position is not appropriate for patients with ___

Answer 66

Suspected spinal, hip, or pelvic injuries or for patients who are unconscious and require ventilatory assistance