Exam 1 - Airway Management 🫀🫁 Flashcards
(202 cards)
1
Q
Pharyngeal airway extend only into ______________.
A
Pharynx
2
Q
What are the two types of oropharyngeal airways?
A
- Berman
- Guedel
3
Q
Which oropharyngeal airway uses a single center channel? Which one uses two?
A
- Guedel uses 1
- Berman uses 2
4
Q
Nasopharyngeal airway is also called what?
A
Nasal trumpet or nasal horn
5
Q
What are indications for nasopharyngeal airways?
A
- Facilitate ventilation
- Removal of secretions by nasotracheal suctioning
6
Q
What are some indications for double-lumen endotracheal tube?
A
- Lung isolation (prevent lung-to-lung spillage of blood pus)
- Surgical procedure on nonventilating lung
7
Q
Removal of the larynx (voice box) is also known as _______________.
A
Laryngectomy
8
Q
What are some indications of artificial airways?
A
- Relief of airway obstruction
- Protection of airway
- Suctioning
- Support ventilation
8
Q
Opening in the neck is called _________________.
A
Tracheostomy
9
Q
Laryngeal Mask Airway (LMA) provides a seal over the larynx with maximum cuff pressure of _____ centimeters of water.
A
60 centimeters of water
10
Q
The process of placing an artificial airway into the trachea.
A
Intubation
11
Q
Oropharyngeal airway must lie _____________________.
A
At the base of tongue above epiglottis with flange outside teeth.
12
Q
Artificial airways placed through mouth and nose into trachea are called ______________.
A
Endotracheal tubes
13
Q
What may occur if EOA enters the trachea?
A
- Tracheal damage
- Asphyxia
14
Q
Indications for LMA
A
- Airway during CPR in profoundly unconscious patients without glossopharyngeal and laryngeal reflexes
- Unable to perform ET intubation
15
Q
Contraindications of LMA
A
- It goes over the pharynx so it does not protect airway from aspiration
- Shouldn’t be used on patients who have not fasted, require emergency resuscitation drug instilled directly into the airway, have severe oropharyngeal trauma, are not profoundly unconscious
16
Q
Esophageal Tracheal Combitude may be inserted where?
A
Esophagus or trachea
17
Q
What are some limitations of LMA? (5)
A
- Unstable airway may cause misplacement of a mask and gastric insufflation
- Cannot withstand high airway pressures (20 cmH2o without gastric distention)
- Not meant for long term use
- Does not protect airway from aspiration
- Requires steam autoclave for reusable LMA (seldomly used)
18
Q
Which medical device is inserted blindly?
A
Esophageal Tracheal Combitude
19
Q
Selection of tracheotomy tubes depends on things like:
A
- Patient’s age, height, airway anatomy
20
Q
The two basic types of tracheal airways are:
A
- Endotracheal tubes
- Tracheostomy tubes
21
Q
_______________ is most often placed in a patient who requires frequent nasotracheal suctioning.
A
Nasopharyngeal airway
22
Q
How does pharyngeal airways prevent airway obstruction?
A
By keeping tongue pulled forward and away from the posterior pharynx. This type of obstruction is common in an unconscious patient as a result of loss of muscle tone.
23
Q
The use of oropharyngeal airway should be restricted to what type of patients?
A
Unconscious patients to avoid gagging and regurgitation.
24
What type of airways extend beyond the pharynx into the trachea?
Tracheal airways
25
____________ tubes are inserted through a surgically created opening in the neck directly into the trachea.
Tracheostomy tubes
26
An ___________ with a rounded tip is used for tube insertion.
Obturator
27
What are the two major limitations of the LMA?
- It cannot be used in a conscious or semicomatose patient because of stimulation of the gag reflex
- If ventilating pressures greater than 20 cmH2O are needed, gastric distention may occur. This device does not protect against aspiration should regurgitation occur.
28
Before insertion of the LMA, the posterior surface of the mask must be lubricated and the cuff must be ______________.
fully deflated
29
What is used to guide the insertion of the LMA along the palate and down into the oropharynx?
Index finger
30
LMAs range in size from size _____ for adults and size ______ for infants.
- 5 for adults
- 1 for infants
31
When intubation is difficult, the patient cannot be positioned for intubation or when the intubator is inexperienced, what would you use?
Laryngeal Mask Airway (LMA)
32
When the LMA cuff is in place, it is inflated to a maximum of __________. Inflation causes the mask to rise slightly out of the mouth.
60 centimeters of water
33
The classic LMA can be used to facilitate intubation because _______________.
The opening faces the glottis.
34
What is this?
LMA
35
What is the tracheotomy tube made of stainless steel called?
The Jackson Tracheostomy Tube
36
What is indicated for patients who retain secretions but do **not** have an artificial airway in place?
Nasotracheal suctioning
37
As the catheter is enters the lower pharynx, the patient should assume what position?
"Sniffing" position
38
________________ is when the ET tube is passed through the nose first.
Nasotracheal intubation
39
________________ is when the ET tube is passed through the mouth on its way to trachea
Orotracheal intubation
40
___________ maintains patient airway by preventing tongue from obstructing oropharynx.
Oral pharyngeal airway
41
What can be used as a bite block for patients with oral tubes?
Oral pharyngeal airway
42
Procedure of establishing access to trachea via neck incision
Tracheotomy
43
What is usually done to treat laryngeal cancer, trauma and radiation necrosis and also be done to treat severe trauma, such as a gunshot wound?
Laryngectomy
44
Uses and precautions of Nasopharyngeal Airway
- Inspect nares for obstructions
- Use local anesthetic spray
- Use water-soluble lubricant on airway
- Size 6 for adult female; Size 7 adult male
45
How do you properly insert a nasopharyngeal airway?
Insert airway parallel to the nasal floor, beveled edge towards septum
46
What medical device cannot be used as an airway for PPV?
Esophageal Obturator Airway
47
____________ resembles a short ET tube with a small cushioned oblong-shaped mask at the distal end.
Laryngeal Mask Airway
48
_____________ is also called a double lumen airway.
ETC - Esophageal-Tracheal Combitude
49
What happens when ETC tube is in the esophagus?
A small distal cuff (15 mL) seals off the esophagus
50
Retained secretions increase airway resistance and the work of breathing and can cause _______________________. (4 things)
- Hypoxemia
- Hypercapnia
- Atelectasis
- Infection
51
What is the application of negative pressure (vacuum) to the airways through a collecting tube (flexible catheter or suction tip)?
Suctioning
52
Difficulty in clearing secretions may be due to what?
Thickness and the amount of the secretions or pt's inability to generate effective cough
53
Suctioning can be performed by way of either __________________.
- The upper airway (oropharynx)
- Lower airway (trachea and bronchi)
54
Why should tracheal suctioning through the mouth be avoided?
It causes gagging
55
There are two techniques for endotracheal suctioning, What are they?
Open and closed.
**OPEN:** Sterile technique requires disconnecting the pt from ventilator.
**CLOSED:** Uses a sterile, closed, in-line suction catheter that is attached to the ventilator circuit so that the suction catheter can be advanced into the patient's endotracheal airway with disconnecting the patient from the ventilator
56
What type of suctioning is when the catheter is inserted in the artificial airway until resistance is met and then withdrawn approximately 1 cm before applying suction?
Deep suctioning
57
Pharyngeal airways prevent airway obstruction by keeping the tongue pulled forward and away from the ___________.
Posterior pharynx
58
In adults, the use of deep tracheal suctioning is being questioned because of what?
The effects of lung volume and oxyhemoglobin saturation
58
Describe shallowing suctioning.
When the catheter is advanced to a predetermined depth, which is usually the length of the airway plus the adapter
59
Suctioning done with lack of clinical indication can lead to unnecessary complications including:
- Hypoxemia
- Bronchospasm
- Mucosal irritation
- Patient discomfort
60
Suction pressure should always be checked by ____________.
Occluding the end of the suction tubing before attaching the suction catheter. The suction pressure should be set at the lowest effective level.
61
What suction pressures are recommended for neonates and adults?
Neonates: Negative pressure of 80 mm Hg
Adults: Less than 150 mm Hg
62
How long are most suction catheters for adults?
22 inches and sized in French units
63
A curved-tip catheter, or catheter coude helps direct access to the ______________.
Left mainstream bronchus
64
What does a too large a suction catheter combined with negative pressure do?
Evacuates lung volume and can cause atelectasis and hypoxemia
65
In infants and children, the diameter of the suction catheter should be less than _______________________.
70% of the internal diameter of the artificial airway
66
In adults, the diameter of the suction catheter should be less than _______________________.
50% of the internal diameter of the artificial airway
67
What type of suction catheter can be used for patients receiving ventilatory support?
An in-line suction catheter
68
In-line catheters have no effect on risk for ventilator-associated pneumonia. T or F?
True
69
What are some indications for the closed suctioning technique?
**Box 37.2
Pg. 751**
**Mechanically ventilated patents with:**
- Positive end expiratory pressure ≥ 10 centimeters of water
- Mean airway pressure ≥ 20 centimeters of water
- Inspiratory time ≥1.5 s
- FiO2 ≥0.60
- Frequent suctioning (≥6 times/day)
- Hemodynamic instability associated with ventilator disconnection
- Respiratory infections requiring airborne or droplet precautions
- Inhaled agents that cannot be interrupted by ventilator disconnection
70
What are potential complications of endotracheal suctioning?
- Hypoxemia
- Cardiac dysrhythmias
- Hypotension or hypertension
- Atelectasis
- Mucosal trauma
- Increased intracranial pressure
- Bacterial colonization of lower airway
71
What can occur with repeated nasotracheal suctioning?
Mucosal trauma and bleeding.
Soft suction catheters and/or nasopharyngeal airway/trumpet is recommended to prevent these complications
72
During nasotracheal suctioning, what happens if you feel resistance during insertion?
Gently twist if any resistance is felt. If twisting does not help, withdraw catheter and insert through the other nostril.
73
__________________ helps maintain the patency of the upper airway despite swelling.
Nasopharyngeal airway
73
Where are oropharyngeal airways inserted?
Into the mouth over the tongue
74
What ensures gas flow if the main port should become obstructed?
a side port, Murphy's eye
75
Why does the inflation of the cuff seal off the lower airway?
For protection from gross aspiration or to provide positive pressure ventilation
76
Included with most ETTs is a **radiopaque** indicator that is embedded in the distal end of the body. What is it for?
It's an indicator that allows easy identification of the tube position on the CXR.
77
How often should a small amount of air be injected into the suction port to ensure tube and tubing are not clogged?
Every 4 hours
78
What prevents tube slippage into trachea and provides the means to secure the tube around the neck?
Flange
79
What tracheostomy made of stainless steel with an inner and outer cannula?
Metal Jackson TT
79
When is the metal Jackson TT generally used?
For patients with a long-term need for an airway but who doesn't require a seal to protect airway from aspiration or to facilitate positive pressure ventilation
80
What does a laryngectomy tube do?
Keeps stoma open until it heals
81
What is the preferred route for establishing an emergency tracheal airway?
Orotracheal intubation
82
What are the basic steps for orotracheal intubation?
**Step 1: Assemble and check equipment** - Vaccum is pressure checked because vomitus or secretions may obscure the pharynx or glottis. Laryngoscope/light source is checked for secured attachment and brightness. Inflate the cuff and check for leaks
**Step 2: Position patient** - The RT flexes the patient's neck and tilts the head backwards, placing the patient into the *sniff position*
**Step 3: Preoxygenate and Ventilate patient** Providing ventilation and oxygenation helps ensure the patient tolerates the procedure
**Step 4: Insert Laryngoscope**
**Step 5: Visualize Glottis**
**Step 6: Displace Epiglottis**
**Step 7: Insert tube**
**Step 8: Assess tube position**
**Step 9: Stabilize tube and confirm placement**
83
ETTs are sized by their ______________________.
Internal diameter (in millimeters)
84
To ease insertion of orotracheal insertion, the outer surface should be lubricated with a _______________.
Water-soluble gel
85
What should be inserted in the ETT to add rigidity and maintain the shape during insertion?
Stylet
86
The tip of the stylet should **NEVER** _____________________.
It should never extend beyond the ETT tip
87
No more than _________ should be devoted to any intubation attempt.
30 seconds
88
If intubation fails, immediate ventilation and oxygenation of the patient for ___________ before the next should occur.
3-5 minutes
89
What hand should the patient use to hold the laryngoscope?
Left hand to hold the laryngoscope and the right hand to open the mouth
90
Explain how the laryngoscope inserted.
It is inserted into the right side of the mouth and moved toward the center
91
Which blade displaces the epiglottis by advancing the tip of the blade into the vallecula (the base of the tongue)?
MacInstoch blade
92
When the tube tip is seen passing through the glottis, it is advanced until ______________.
Until the cuff has passed the vocal cords
93
Which blade displaces the glottis directly by advancing the tip of the blade over its posterior surface and the laryngoscope is lifted **up and forward?**
Straight blade, Miller
94
Ideally, the tip of an ETT tube should be positioned in the trachea approximately _____________ above the carina.
3-5 cm
95
Air movement or gurgling sounds over the epigastrium indicate what?
Esophageal intubation
96
The combination of decreased sounds and decreased chest wall movement on the left side indicates ______________.
Right main stem intubation
97
How is right main stem intubation corrected?
By slowing withdrawing the tube while listening for the return of left-side breath sounds
98
What is the average length from the teeth to the tip of a properly positioned oral ETT in men and women?
Men: 21 cm
Women: 23 cm
99
In patients with _____________, expired CO2 levels may be near zero because of poor pulmonary blood flow, yielding a false-negative result.
cardiac arrest
100
What is the **most common** complication of emergency airway management?
Tissue trauma
101
What are the most _serious complications_ of emergency airway management?
- Acute hypoxemia
- Hypercapnia
- Bradycardia
- Cardiac arrest
102
Nasotracheal intubation can only be performed by direct visualization. T or F?
False, it can be inserted blindly as well.
103
Blindly inserting a nasotracheal tube will only work if the patient is _____________.
Breathing spontaneously
104
During nasotracheal intubation, they use _________ with the right hand to grasp the tube just above the cuff and direct it between the vocal cords.
Magill forceps
105
For blind nasal intubation, describe the breath sounds when the passes through the larynx?
Becomes louder and more tubular
106
Successful passage of the tube through through the larynx is usually indicated by what?
Harsh cough followed by a vocal silence. If the sounds disappear, the tube is moving toward the epiglottis
107
What is the **preferred**, primary route for overcoming upper airway obstruction or trauma for patients with poor airway reflexes?
Tracheotomy
108
A small opening between the posterior wall of the trachea and esophagus
Tracheoesophageal puncture (TEP)
109
If a patient still needs an artificial airway after 7 to 14 days, what is commonly considered?
Tracheostomy
110
What are some benefits of the tracheostomy tube versus the oral or nasal intubation?
- Elimination of vocal injury
- Increased patient comfort
- Less need for deep sedation
- Easier removal of secretions
- Decreased work of breathing
- Potentially shorter weaning time
111
What are some factors to consider in switching from endotracheal tube to tracheostomy?
- Projected time patient will need artificial airway
- Pt's tolerance of endotracheal tube
- Pt's overall condition (nutritional, cardiovascular, infection status)
- Pt's ability to tolerate surgical procedure
112
In traditional surgical tracheotomy, the surgeon makes an incision in the neck over the ____________.
second or third tracheal ring
113
Before the removal of the larynx, the surgeon does what?
Creates a hole in the neck (stoma) and attaches the trachea to the stoma. The patient will breathe through that permanent stoma
114
If a patient who's had a full laryngectomy loses the artificial airway, what is the job of th RT?
Apply bag-mask ventilation over the stoma, usually a pediatric mask
115
If a patient who's had a partial laryngectomy loses the artificial airway, what is the job of th RT?
RT would cover the stoma with a gauze pad and apply bag-mask ventilation over the nose and mouth with standard adult mask
116
Artificial airways do not conform exactly to patient anatomy, which may result in pressure on soft tissues that can result in _______________________.
Ischemia and ulceration
117
Artificial airway tend to shift positions as the patient's head and neck move or as the tube is manipulated. This shifting can cause what?
Friction-like injuries
118
What are the most common laryngeal injuries associated with endotracheal intubation?
- Glottic edema
- Vocal cord inflammation
- Laryngeal or vocal cord ulcerations
- Vocal cord polyps
- Granulomas
**Less common and more serious:**
- Vocal cord paralysis
- Laryngeal stenosis
119
What are the primary symptoms of glottic edema and vocal cord inflammation?
Hoarseness and stridor
120
What is the treatment goal of epinephrine used for stridor?
Reduce glottic edema or airway edema by mucosal vasoconstriction
121
To reduce laryngeal edema in patients who have had prolonged intubation or patients who have failed prior extubation because of glottic edema, what is given 24 hours before extubation?
IV steroids and/or diuretics
122
________ is likely in extubated patients with hoarseness and stridor that does not resolve with treatment or time.
Vocal cord paralysis
122
What occurs when the normal tissue of the larynx is replaced by scar tissue?
Laryngeal stenosis
122
What is the most common way to secure ETTs?
With tape
122
What is one of the most frustrating aspects of caring for a tracheal tube?
His or her inability to talk
123
_____________ can help keep patients comfortable and decrease the likelihood of self-extubation.
Sedation
123
____________ are easier to stabilize and may move less than orotracheal tubes.
Nasotracheal tubes
124
What should be done to minimize vocal cord closure around ETTs?
Patients should be discouraged from unnecessary coughing or efforts to talk.
125
Tracheal wall injury from the endotracheal tube can be reduced by maintaining pressures of __________.
20 to 30 centimeters of water
126
What can be used to minimize tube traction whenever the RT equipment is attached to tracheostomies?
Swivel adapters
127
If there is significant drainage from the stoma, it is better to use _______ rather than standard gauze, which would keep the skin wet when moist.
Foam dressing
128
What are the 7 critical responsibilities of airway maintenance?
1. Securing the tube and maintaining proper placement
2. Providing for patient communication
3. Ensuring adequate humidification
4. Minimizing possibility of infection
5. Aiding in secretion clearance
6. Proving appropriate cuff care
7. Troubleshooting airway-related problems
129
_________ allow vocal cord movement but prevents air flow.
Standard TTs
130
What TT has special speech cannula that allows ventilator-dependent patients with the cuff fully **inflated?**
the Blom fenestrated TT
131
What patient would be a good candidate for the speaking valve?
Medically stable patient with low risk of aspiration
132
During the initial placement of the speaking valve, the patient's ability to exhale around the TT should be assessed by measuring ________________.
Tracheal pressure during exhalation with the valve in place
133
A speaking valve can aid in communication and can be safely used if tracheal pressures are less than what?
5 cm H2O
134
What does tracheal pressure greater than 5cmH2O indicate?
Increased resistance during exhalation
135
What are the most common causes for a tracheal pressure greater than 5 cmH2o?
Relative to the size of the trachea, tube position, inadequate cuff deflation or a upper airway abnormality
136
**Rule of thumb:** The tracheostomy tube cuff must be completely deflated before a speaking valve is placed on the tracheostomy tube.
Know this.
137
Selection of a humidification device ultimately should be based on :
- Patient needs
- Assessment of airway
- Volume and thickness of secretions
- History of mucous plugging or tube occlusion
138
Patients with tracheal airways are very susceptible to bacteria colonization and infection of the _________________.
Lower respiratory tract
139
To guard against infection, the clinician first should avoid introducing organisms into the airway. How does the clinician do this?
- Adhering to sterile technique during suctioning
- Ensure that only aseptically clean or sterile respiratory equipment is used for each patient
- Consistently performing hand hygiene between patient contacts
140
What is the most common cause of airway obstruction in critically ill patients?
Retained secretions
141
What is this called?
Yankauer suction tip
142
What are tracheal tube cuffs used for?
Mechanical ventilation or to prevent or minimize aspiration
143
What are some techniques that decrease the consequences of pharyngeal aspiration?
- Use of medications for stress ulcer prophylaxis, such as sucralfate, that maintain normal gastric pH
- Positioning the patient with the head of the bed elevated 30 degrees or more to decrease reflux
- Continuous aspiration of subglottic secretions
144
To decrease the possibility of aspiration with feedings, the head of the bed should be elevated ________ or more when possible.
30 degrees
145
What are some things that can cause tube obstruction?
- Kinking of the tube or patient biting the tube
- Herniation of the cuff over the tip
- Obstruction of the tube orifice against tracheal wall
- Mucous plugging
146
If tubing is kinked or positioned against the tracheal wall, how can this be reversed?
Moving the patient's head and neck and repositioning the tube. If this action does not relieve the obstruction, a herniated cuff may be blocking the airway
147
An ETT that is positioned ___________ can mimic a cuff leak.
Too high in the trachea and near the glottic opening
148
What is the process of removing an artificial airway called?
Extubation (ETT) or decannulation (TT)
149
A patient is ready to be extubated when __________________.
When the need for the artificial airway no longer exist
150
How does the cuff-leak test help predict the occurrence of glottic edema or stridor during extubation?
The clinician totally deflates the tube cuff and assesses the leak around the tube during positive pressure ventilation in a volume-controlled mode. The pressure of the leak should be **15%** or greater.
151
In what type of patients is the cuff-leak test most useful in what kind of patients that are at greater risk of postextubation stridor?
- Children
- Women
- Patients intubated for more than 6 days
152
What is the set suction pressure for **adults?**
120-150 mm Hg
153
What is the set suction pressure for **children?**
100-120 mm Hg
154
What is the set suction pressure for **infants?**
80-100 mm Hg
155
What are the list of things you need for extubation?
- Oxygen
- 10cc syringe
- Towel
- Stethoscope
- Intubation box/cart
156
___% of unplanned extubation do not require reintubation.
50 percent
157
Total suction time should be kept to _________________.
Less than 15 seconds
158
Removal of foreign bodies, secretions, or tissue masses beyond the mainstem bronchi requires what?
Bronchoscopy
159
What technique would you use to suction a trach patient?
Open sterile technique is often used.
160
Using shallow rather than deep suctioning is recommended in infants and in adults the us of deep tracheal suctioning is being questioned because of what?
Its effects on lung volume and oxyhemoglobin saturation
161
Most suction catheters for adults are _____ inches long.
22
162
Before suctioning, delivery of **100%** oxygen for _____________ is suggested.
30-60 seconds
163
What are the steps for suctioning?
1. Assess patient for indications
2. Assemble and check equipment
3. Assess patient for hyperoxygenation
4. Insert catheter
5. Apply suction and clear catheter
6. Reoxygenate patient
7. Monitor and assess outcomes
164
What happens if any outward response occurs during suctioning?
Catheter should be removed immediately and the patient should be oxygenated
165
What are some complications of nasotracheal suctioning?
**- Gagging and/or regurgitation**
**- Airway trauma (bleeding)**
**- Contamination of the lungs**
**- Bronchospasm or laryngospasm**
166
What is used to monitor cuff status and pressure when the tube is in place?
Pilot balloon
166
On a TT, what prevents tube slippage into the trachea and provides means to secure the tube to the neck?
Flange
167
What is this called?
Laryngectomy tubes
168
Which hand do you hold the laryngoscope with?
Left!
169
The laryngoscope is inserted into which side of the mouth?
Right side of the mouth and moved toward the center, displacing the tongue to the left
170
As the laryngoscope reaches the base of the tongue, the RT looks for what?
The arytenoid cartilage and epiglottis
171
If a light wand is used during intubation, as the stylet and ETT pass into the larynx, a characteristic glow is seen under the skin, just above the _______________.
Thyroid cartilage
172
How is the patient positioned for blind nasal intubation?
Supine or sitting position
173
What are some risks associated with laryngectomy?
- Hematoma
- Wound infection
- Fistulas
- Stomal stenosis
- Leaking around tracheoesophageal prosthesis
- Difficulty swallowing and eating
- Problems speaking
174
What is binocular vision?
Direct vision of the vocal cords and NOT losing the sight of it until the tube is inserted
175
What is the "safety pin" used for?
To prevent nasal airway from advancing too far or migrating outward
176
During which part of the breathing cycle do we extubate?
End-expiration
177
What is kept at the bedside for trach patients in case or reinsertion?
Obturator
178
How do you measure oropharyngeal airways?
Measure from the corner of the patient's mouth to angle of the jaw
179
Too large of an airway can do what?
Push the epiglottis against the larynx, leading to airway obstruction
180
Too long of a nasopharyngeal tube may do what?
Enter the larynx, causing laryngeal reflexes or enter the space between the epiglottis and vallecula, leading to potential airway.
181
How do you measure nasopharyngeal tubes?
By going from the patient's ear lobe to the tip of the nose
182
Too short of a nasopharyngeal tube _______________________.
Cannot separate soft palate from posterior wall of pharynx
183
ET intubation may be done with an EOA in place. True or False?
True
184
What happens when ETC tube is in the trachea?
A large proximal cuff (100 mL) seals off trachea
185
What are the two types of endotracheal tubes?
Oral and nasal
186
One-way valve that allows inspiration but not exhalation through tracheostomy tube opening
Speaking valves
187
What supplies do you need for intubation?
- Laryngoscope
- Blade (Mac or Miller)
- ET tube
- 10-mL syringe
- Water-soluble lubricant
- Stylet
- ET tube securing device
- CO2 detector
188
How can partial displacement of airway out of trachea be detected?
- Decreased breath sounds
- Decreased airflow through tube
- Decreased ability to pass catheter past end of tube
189
______________ is the softening of the cartilaginous rings, which causes collapse of the trachea during inspiration and expiration.
Tracheomalacia
190
A narrowing of the lumen of the trachea, which can occur as fibrotic scarring, causing the airway to narrow.
Tracheal stenosis
191
Stenosis at the stoma site is associated with what?
- Too large a stoma
- Infection
- Movement of the tube
- Frequent tube changes
- Advanced age
192
Dyspnea at rest may not be seen until the diameter of the trachea is less than ________.
5 mm
193
What is this?
Blom fenestrated trach tube with speech cannula
