CP 2013 Viva study

Card Set Information

Author:
jessiekate22
ID:
222290
Filename:
CP 2013 Viva study
Updated:
2013-06-04 02:41:58
Tags:
Artificial Airways
Folders:

Description:
Week 5 L3
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user jessiekate22 on FreezingBlue Flashcards. What would you like to do?


  1. When is a NIV airway used?
    • - to maintain an airway
    • -reduce pharyngeal mm tone
    • - suctioning
  2. What is NIV airways?
    • - devices that do not end up in your lungs
    • - Oropharyngeal 
    • - Nasopharyngeal
  3. What type of airway is a guedels?
    • - NIVairway
    • - Oropharyngeal airway
  4. What is this airway?
    - guedels airway
  5. What is the guedels airway used for?
    • - keep the oropharynx open
    • - make it easier to suction
  6. Describe how to insert a guedels:
    • - upside down- to compress the tounge 
    • - twist to sit flt
  7. Name the parts of the guedels!
  8. What is the oropharyngeal airways?
    - guedels
  9. What are some complications with the oropharyngeal airways?
    • - muscosal trauma
    • - obstruction if airway is too small
    • - posterior displacement of the tongue- obstruction
    • - gagging and vomiting- aspiration
    • - biting on the tube
    • - patient distress
  10. What is the nasopharyngeal airway?
    • - airway inserted into the nose to the trachea
    • - used for suctioning
    • - good for when a pt needs to be suctioned a number of times
  11. How do you size a NP airway?
    • - noone really knows
    • - but bigger is better
  12. How do you insert a NP airway?
    • - lube
    • - in nose
    • - aim for opposite eye
    • - push in
  13. What are some complications of a NP airway?
    • - not comfy
    • - need another person to hold them down
    • - can cause obstruction
    • - can cause trauma
  14. What is this?
    • - NP airway
  15. What is Endotracheal intubation?
    • - the insertion of the ETT tube either oro or naso
    • - can get naso ones for kids
    • - this is the gold standard for airway management
  16. When should an ETT be inserted?
    • - acute airway obstruction
    • - facilitation of suctioning
    • - protection of airway
    • - resp failure requiring ventilatory support and need an increase in O2 requirements
  17. What is this?
    And name the parts
    • - cuff
    • - pilot tube of ETT- to inflate cuff
  18. How would you ensure the ETT is in the correct position?
    • - Xray
    • - flow chart- the cm that is meant to be at the mouth
  19. What is this and where do the parts sit?
    • Swan Ganz Catheter
    • A = right atrial lumen
    • B = thermistor
    • C = mixed venous oximeter
    • D = pulmonary artery lumen
    • E = balloon inflation/deflation
  20. How do they intubate a pt?
    • - with the use of laryngoscope or fibreoptic bronchoscopy
    • - head in ext
    • - ETT to sit 3-4 cm about the carina
    • - inflate cuff
  21. What is the role of the cuff in an ETT?
    • - secures the ETT in place
    • - ensures there is a closed system
    • - NOTE with kids dont use cuffs
  22. ETT and sizes- why important?
    • - different sizes based on inside diameter- for girls 8mm
    • - too big can cause necrosis
    • - too small cuff wont seal- you will hear a gurgle
  23. What happens if the ETT goes too far down?
    - goes into the right
  24. What happens if the cuff has too much or too little pressure in it?
    • - too much- may cause necrosis
    • - too little- wont secure it in place
  25. What is the normal cuff pressure for an ETT?
    • 25- 30mmHg 
    • - check with a manometer
  26. What are the two techniques for intubation?
    • - direct laryngoscopy
    • - fibreoptic bronchoscopy- camera and light
  27. Endotracheal intubation important points?
    • - must preoxygenate
    • - oxygenation during attempts
    • - must have suction equipment available
    • - pt often sedated and paralysed
  28. How do you confirm the position of the ETT?
    • - direct visualisation of the position with the bronchoscope
    • - auscultation 
    • - chest wall movement
    • CXR
  29. What are some of the complications of the ETTs during intubation?
    • - injury to mouth or nose
    • - dental injury
    • - mucosal damage
    • - laryngeal injury
    • - injury to the recurrent laryngeal nerve
    • - oesophageal intubation
    • - aspiration
    • - hypoxaemia
    • - tracheal rupture
    • - oesophageal perforation
    • - stimulation of the resp tract- can result in triggering of cardiac, airway, cerebral, neuromuscular responses
    • - stimulation of vagus nerve
    • - drugs used to intubate can also trigger haemodynamic responses
  30. What are some complications of ETT while tube is in mouth?
    • -migration of tube
    • - blockage of tube
    • - loss of normal URT defence mechanisms
    • - loss of URT heating and humidification
    • - damage to vocal cords- reduction in adductor activity of the laryngeal mms- poor glottic closure
    • - damage to airway from tube and cuff
  31. What are some of the complications of the ETT post removal?
    • - some problems may not become obvious unit pt isextubated
    • - laryngeal damage
    • - tracheal stenosis
    • - aspiration
  32. What are complications of the ETT associated with?
    • - emergency intubation
    • - pt position- head needs to be tilted back
    • - pt anatomy- obese people are hard to intubate
    • - experience of the operator
  33. What are some pts symptoms post extubation of the ETT?
    • Acute:
    • - stridor
    • - resp distress
    • - need for reintubation
    • Other
    • - sore throat
    • - hoarseness
    • - paranasal sinusitis
  34. Suctioning with an ETT:
    - how often?
    - saline?
    - sterile or clean?
    • - suction as often as needed
    • - sometimes saline can help- but evidence doesnt support this
    • -
  35. What do you need to be careful of when treating someone with an ETT?
    • - dont pull it out
    • - dont move it too much
    • - when moving pt ensure someone is watching the head
    • - when percs and vibes always suction
    • - check for pressure areas
  36. What is a tracheostomy?
    • - accessing the airway through the trachea below the level of the vocal cords
    • - Has become more common as materials have improved
    • - Hx 2-3000yrs
  37. What is this?
    - trachestomy
  38. What are the parts of a tracheotomy?
  39. Why would you perform a trachea?
    • - provide airway access for anyone who has been intubated/ ventilated for a long period of time
    • - bypass any obstruction above the glottis
  40. When is a trachea considered?
    • - complex decision based on multiple individual factors
    • - intubated and ventilated longer than 10 days
  41. What are the benefits of a tracheostomy?
    • - reduced airway resistance (shorter tube)
    • - quicker weaning off mechanical ventilation
    • - easier clearance of secretions
    • - easier facilitation of normal swalowing, speech
    • - increased patient mobility
    • - increased patient comfort
    • - less sedation required
    • - more secure airway
    • - easier to reinsert
    • - nothing in mouth
  42. What are some of the disadvantages of a tracheostomy?
    • - surgical technique with associated complications
    • - tracheal damage
    • - permanent scar
    • - bypass normal URT defences
    • - infection at site of stoma/ hole
  43. What are the ways to insert a trachea?
    • - hole = stoma
    • - percutaneous- in unit and intensivists do it
    • - surgical- people with huge necks and you cant get a visual of the anatomy
  44. What are the different types of tracheostomy?
    • - cuffed and uncuffed
    • - fenestrated (hole in it)/ unfenstrated
    • - talking/ speaking traches
  45. When would you use cuffed or uncuffed tracheas?
    • Cuff
    • - as for ETT
    • - implications in tracheal damage
    • Uncuffed tubes:
    • - used in children
    • - used for weaning from ventilation and prior to removal of trache
    • - may be used for those requiring suctioning but mechanical ventilation
  46. What is a fenestrated tracheostomy?
    • -holes along the length of the tube above the cuff
    • - allow air to pass thru the URT
  47. How can you speak with a trachea?
    • - cuff down/ fenestrated tube
    • - finger over the end
    • - special speaking valves- valves open during inspiration and closes during expiration
  48. What can a trachea be attached to?
    • - HME
    • - Ladells bag
    • - inline suction
    • - trachea bag
  49. Tracheostomy care
    • - monitor cuff pressure
    • - suctioning
    • - dont pull it out
    • -dont stand in front of a pt when they cough
    • - goggles
  50. How to assess a pt with a trachea or ETT
    • - as per usual resp assessment
    • - Differences
    • - no ability to talk
    • - auscultation
    • - no ability to cough but huff??

What would you like to do?

Home > Flashcards > Print Preview