Egans CH 37 Int & Ext

Vocabulary flashcards covering key terms and definitions from the lecture notes on intubation and airway management.

Intubation

Process of placing an artificial airway into the trachea.

Endotracheal tube (ETT)

Artificial airway tube inserted through mouth or nose into the trachea.

Orotracheal intubation

Endotracheal tube passed through the mouth on its way into the trachea.

Nasotracheal intubation

Endotracheal tube passed through the nose first.

Artificial airway

Airways placed to maintain ventilation; through mouth/nose (ETT) or through the neck (tracheostomy tubes).

Pharyngeal airway

Airway device that extends only into the pharynx.

Nasopharyngeal airway (NPA) and how to place

Nasal airway to facilitate frequent nasotracheal suctioning; minimizes nasal mucosa damage; size is nose to tip of ear lobe, NPA diameter is smaller than pts nares; bevel toward septum; lubricated; flange rests at nostril.

Oropharyngeal airway (OPA)

Oral airway used in unconscious patients to maintain patient airway by preventing tongue obstruction and may serve as a bite block for pts w/ oral tubes.

How to place an OPA

OPA sized by measuring from center of mouth to angle of jaw, or corner of the mouth to earlobe; place oral airway in mouth w/ curved end towards roof or side of mouth, when inserting device and approaches posterior pharynx rotate device 180 degrees into correct position.

Laryngeal mask airway (LMA)

Supraglottic airway for quick, temporary ventilation in difficult to intubate patients or short surgeries.

i-gel

Brand of supraglottic airway (gel-like) used as an alternative to LMA.

Double-lumen endotracheal tube

ETT with two channels enabling independent lung ventilation.

Combitube

Esophageal–tracheal tube used for difficult intubations or when ventilation or intubation cannot be achieved.

Esophageal–tracheal Combitube

A Combitube designed to function in both esophagus and trachea for airway management in difficult cases.

Mac blade

Curved laryngoscope blade commonly used in adults.

Miller blade

Straight laryngoscope blade used for infants/children.

Magill curve

Curvature used in airway instrumentation (Magill curve radius referenced in equipment).

Bevel

Slanted, angled tip of an endotracheal tube.

Murphy Eye

Side hole near the distal end of an endotracheal tube.

Pilot balloon

Inflation/deflation balloon for the ETT cuff.

Cuff

Inflatable ring on the ETT that seals the airway when inflated.

Carina

Bifurcation of the trachea into the left and right main bronchi; ETT tip should be 3–5 cm above it.

Glottis

Opening between the vocal cords.

Vocal cords

Vocal folds within the larynx; visualized during intubation.

Epiglottis

Flap that covers the glottis; displaced during laryngoscopy to visualize the airway.

Vallecula

Anatomical space used as a landmark where the laryngoscope tip is placed to visualize the glottis.

Capnography

Real-time CO2 waveform used to confirm ventilation and correct tube placement.

Capnometry

Measurement of the concentration of CO2 in exhaled air.

End-tidal CO2

CO2 level at the end of expiration; used to verify ventilation and tube position.

CO2 detector / colorimetric

Color-changing device that indicates the presence of CO2 and helps confirm ETT placement.

Securement device

Device or method (e.g., adhesive tape) used to fix the ETT in place.

Extubation

Process of removing an endotracheal tube.

Nasal cannula

Oxygen delivery device inserted into the nostrils.

Pre-oxygenation

Preoxygenating the patient with high FiO2 before induction to extend safe apnea time.

Laryngoscope

Instrument with blades (Mac or Miller) used to visualize the larynx during intubation.

Pre-oxygenate and ventilate

Preoxygenate the patient and ventilate prior to laryngoscopy to optimize oxygenation.

Steps to intubation

1. Assemble & check equipment

2. Position pt.

3. Pre-oxygenate & ventilate pt.

4. Insert laryngoscope

5. Visualize glottis

6. Displace epiglottis

7. Insert tube

8. Assess tube position

9. Stabilize tube/confirm placement (Listen for equal & bilateral breath sounds as pt. ventilated)

10. Secure ETT

Steps of extubation

1. Assemble needed equipment

2. Suction ETT tube nad pharynx above cuff

3. Oxygenate pt.

4. Remove securement device

5. Deflat cuff

6. Remove tube

7. Apply appropriate O2 & humidity therapy (O2 w/ cool mist)

8. Assess/reassess pt. (check for good air movment via auscultation, check for stridor, check pts. skin color, check pts. SpO2)

Describe unplanned extubation

Assess pt. readiness for extubation, OG problem no longer present, quantity & thickness of secretions, upper airway patency, presence of intact gag reflex, ability to clear airway secretions

Equipment for intubation

ETT (stylet, 10 mL syringe, securement device), check cuff is not broken, place stylet inside ETT & full 10 mL syringe on pilot balloon

Bag/mask w/ O2 source

Laryngoscope (Mac for adults, Miller for infants/children)

Suction on & working

CO2 detector or capnography

Vent for after intubation

Sometimes OP airway & bougie

Equipment for extubation

Nasal Cannula

O2 source

Towel

Pulse ox & HR monitor

Suction inline & yankauer

Ambu-bag/mask

Re-intubation supplies on standby if previously diff. intubation

Racemic epinephrine, if known hx of laryngeal spasm (w/ nebulizer)