NOVA- Anesthesia Principles of Airway quiz 2

Protection, conduction, and air conditioning

What does the airway do naturally that we need to help the pt do?

EtCO2

What monitor will show that your patient is in trouble before desaturation will show?

Low flow device

-oxygen is supplied at a fixed flow that is only a portion of the inspired gas

-most common and cheap

-as ventilatory demands change, variable amounts of room air will dilute the oxygen flow

-intended for patients with stable breathing patterns

High flow devices

-inspired gas at a preset FiO2 is supplied continuously at _______ or by providing a large reservoir

-ideally, FiO2 is not affected by variations in patients breathing patterns

-consistent FiO2 with a larger inspiratory flow of gas

Low flow devices

-nasal cannulas

-simple face masks

-partial rebreathing masks

-nonrebreathing masks

-tracheostomy collars

0.24-0.44

FiO2 range?

4%

Each one liter per minutes flow increase is assumed to equal _____ increase in O2%

0.25-6L/min

What is the flow rate range?

Humidification

5L/ min or greater requires what?

0.24

1 L/min

0.28

2 L/min

0.32

3 L/min

0.36

4 L/min

0.40

5 L/min

0.44

6 L/min

Nasal canula flow range

0.21-0.44

Simple mask

0.30-0.60

Partial rebreathing mask bag

0.35-1.00

Nonrebreathing mask-bag

0.40-1.00

Simple face mask

-disposable, lightweight plastic device that covers both the nose and the mouth

-mask is an additional 100-200mL O2 reservoir

-minimum flowrate 5L/min- limits rebreathing CO2

-maximum 8L/min- reservoir is completely full

-FiO2 range (0.40-0.60)

Partial rebreather

-simple facemask with reservoir bag and side ports to allow entrainment of room air and an outlet for exhaled gases

-part of the patients expired Vt refills the bag

-should NOT completely collapse on inspiration

-FGF should be 8L/min or greater

-FiO2 range (0.60-0.80 PLUS)

Non rebreather mask

-acts like a partial rebreather but has 3 unidirectional valves

-2- permits venting of exhaled gases and prevents room air entrainment

-1- between the mask and reservoir bag prevents the exhaled gases from entering the bag

-need high flow of O2 so the reservoir bag is at least partially full during inspiration

-typical minimum flow O2: 10-15L/min

-FiO2 (0.80-0.90 PLUS)

Tracheostomy collars

-used to deliver humidified O2 to tracheostomy pts (low flow)

-FiO2 is unpredictable

Face shield

-used to deliver humidified O2 to pts who are not tolerating a face mask or nasal canula well

-FiO2 is unpredictable

High flow

What kind of flow is independent of a patients respiratory pattern?

Oral and nasal routes

What are two passages for relieving obstruction?

-adjunct for physical support

The tongue falls into the back of the throat

What happens to the airway during an anesthetic?

Oral airway

-obstruction relieved by repositioning the head and/or jaw thrust

Sniffing position

-head extension

-neck flexion

Rotational TMJ movement

Movement that occurs when the mouth opens and closes around a fixed axis within the TMJ

Translational TMJ movement

Mandible advance anteriorly by the sliding motion of the condyles in the TMJ

Oral airways

-guedel

-berman

-insert with a tongue depressor to prevent trauma

-protects the endotracheal tube from being bitten and occulded

-size by angle of the jaw to corner of the mouth

Berman OAW

-body

-central support

-open sides for air channels

-flange

Guedal OAW

-body

-central lumen

-flange

Oral airway is too long

Obstructs the larynx by forcing down the epiglottis

Oral airway is too short

Pushes tongue into airwar

Nasal airway

-indicated when semiconcous pt is not tolerating an OAW

-nasotracheal intubation guide in maxillofacial trauma

-dilation of nasal passage for nasal intubation

-size by distance from tip of nose to meatus of ear (length is more important than width)

-sized in french: 24Fr, 28Fr, 30Fr, 32Fr, and 34Fr

Positive pressure ventilation

-bag mask ventilation

-laryngeal mask airway (LMA)- attending permitted

-endotracheal tube (ETT)

Spontaneous ventilation (negative pressure)

-bag mask ventilation

-laryngeal mask airway (LMA) most common use

-endotracheal tube (ETT)

EC grip

How should you hold the mask when bagging a pt?

Suction catheters

-rigid- yankauer

-flexible or soft

-naso/orogastric tube