Chapter 5, Airway and Ventilation

Question 1

What are some factors that adequate perfusion depends upon?

Answer 1

Airway patency
Ventilators effort
Gas exchange in the alveoli
Hemoglobin’s oxygen-carrying capacity
Cardiac output

Question 2

What is SaO2?

Answer 2

The percentage of oxygen-saturated hemoglobin in arterial blood

> 95%

Question 3

What is SpO2?

Answer 3

The percentage of saturated hemoglobins in the capillary bed.

> 94%

Question 4

What is PaO2?

Answer 4

Amount of oxygen dissolved in plasma.

> 80 mmHg

Question 5

What is PaCO2?

Answer 5

Partial pressure of carbon dioxide in arterial blood.

35-45 mmHg

Question 6

What is ETCO2?

Answer 6

Maximum concentration of CO2 at the end of each breath.

35-45 mmHg

Question 7

What is FiO2?

Answer 7

Fraction of oxygen in the air mixture that is delivered to the patient.

0.21 (room air) - 1% (100% oxygen)

Question 8

What is hypoxemia?

Answer 8

PaO2 < 80 mmHg (normal = 80-100 mmHg)

Question 9

What is hyperoxia?

Answer 9

PaO2 > 100 mmHg (normal = 80-100 mmHg)

Question 10

What is assumed when patients have distracting injuries and altered mental status?

Answer 10

That they have sustained a spinal cord injury.

Question 11

What are two ways to achieve spinal motion restriction (SMR)?

Answer 11

Manual stabilization
Semi-rigid cervical collar

Question 12

How should the airway be opened in a patient that is unable to open their mouth, responds only to pain, or is unresponsive?

Answer 12

Jaw-thrust maneuver

Question 13

How do you assess the placement of a definitive airway?

Answer 13

CO2 detector after 5-6 breaths
Observe rise and fall of the chest
Auscultate (over epigastrium and chest)

Question 14

How should oxygen to the trauma patient be delivered initially?

Answer 14

10-15 LPM via nonrebreather mask

Question 15

How should breaths be delivered using a bag-mask device?

Answer 15

1 breath every 6 seconds (10 breaths per minute)
Over 1 second
Attached to an oxygen source

Question 16

What may occur if excessive volume is delivered via the bag-mask device?

Answer 16

Gastric distention
Vomiting
Aspiration
Barotrauma

Question 17

Who is a candidate for a NPA?

Answer 17

Conscious
Semi-conscious
Intact gag reflex

Question 18

When is a NPA contraindicated?

Answer 18

Facial trauma
Basilar skull fracture

(Risk for placing in cranial cavity)

Question 19

How do you determine the length of an NPA?

Answer 19

Tip of the patient’s nose to the tip of their earlobe.

Question 20

Who is a candidate for a OPA?

Answer 20

A patient without a gag reflex.

Question 21

How do you measure an OPA?

Answer 21

From the corner of the mouth to the angle of the mandible.

Question 22

What are examples of a supraglottic airway?

Answer 22

I-gel, LMA.

Question 23

What is an example of a retroglottic airway?

Answer 23

King tube.

Question 24

What are the indications for immediate definite airway management?

Answer 24

Failure of the patient to protect their airway.
Failure to maintain oxygenation or ventilation.
A specific, anticipated clinical course.

Question 25

What isolation precautions must be taken when placing an ETT?

Answer 25

Contact & airborne precautions.

Question 26

What are two methods to perform a cricothyroidotomy?

Answer 26

Needle catheter Surgical insertion

Question 27

What is a mnemonic to assess for airway difficulty?

Answer 27

L: Look externally (trauma, deformity, abnormal anatomy) E: Evaluate (3,3,2) M: Mallampati score (evaluates mouth opening to size of tongue) O: Obstruction/obesity (hematoma, upper airway injury) N: Neck mobility (cervical spine stabilization)

Question 28

What is DAI?

Answer 28

Drug assisted intubation

Question 29

What is RSI?

Answer 29

Rapid sequence intubation Use of sedative followed by neuromuscular blocking agent

Question 30

What is a prerequisite tor DAI?

Answer 30

High flow preoxygenation at max concentration for at least 3 minutes.

Question 31

How does one secure and verify ETT placement?

Answer 31

Note the measurement at the teeth or gums and document. Chest radiograph.

Question 32

What is a sign of improved outcomes and mortality rates pertaining to lactate?

Answer 32

Stabilization within 24 hours.

Question 33

What does a shift to the right indicate on the oxyhemoglobin dissociation curve?

Answer 33

An environment of high metabolic demand. Hemoglobin’s affinity for oxygen decreases. Decreased pH. Increased Pco2. Increased temp.

Question 34

What does a shift to the left indicate on the oxyhemoglobin dissociation curve?

Answer 34

An environment of low metabolic demand. Hemoglobin’s affinity for oxygen increases. Increased pH. Decreased Pco2. Decreased temperature.

Question 35

What is a mnemonic to troubleshoot ventilator, capnography, or pulse oximetry alarms?

Answer 35

D: Displacement O: Obstruction P: Pneumothorax/tension pneumothorax E: Equipment (tubing leak, cuff pressure loss, disconnection)

Question 36

What are the 7 Ps of RSI?

Answer 36

Preparation Preoxygenation Preintubation optimization Paralysis with induction Positioning with protection Placement with proof Postintubation management