Podcast
Questions and Answers
What is a primary characteristic of an endotracheal tube (ETT)?
What is a primary characteristic of an endotracheal tube (ETT)?
- It is flexible and conforms to the patient's anatomy for comfort.
- It is designed for long-term airway management, typically weeks to months.
- It is made of a bio-absorbable material that dissolves over time.
- It is semi-rigid and radiopaque, used for temporary airway patency. (correct)
What factor is MOST important when determining the appropriate size of an endotracheal tube?
What factor is MOST important when determining the appropriate size of an endotracheal tube?
- Patient's age and medical history.
- Physician preference.
- Patient's size; whether the tube is placed nasally or orally. (correct)
- Availability of tube sizes in the emergency department.
What is the recommended internal diameter range (in mm) for an endotracheal tube in adult males?
What is the recommended internal diameter range (in mm) for an endotracheal tube in adult males?
- 7.0 - 7.5
- 7.5 - 8.0
- 6.5 - 7.0
- 8.0 - 9.0 (correct)
What is the purpose of the cuff on an endotracheal tube?
What is the purpose of the cuff on an endotracheal tube?
After intubation, what confirmatory assessment is MOST reliable for ensuring proper endotracheal tube placement?
After intubation, what confirmatory assessment is MOST reliable for ensuring proper endotracheal tube placement?
In the mnemonic 'DOPE' used to identify possible causes of deterioration in an intubated patient, what does 'P' stand for?
In the mnemonic 'DOPE' used to identify possible causes of deterioration in an intubated patient, what does 'P' stand for?
What is the MOST critical requirement a patient must meet prior to extubation?
What is the MOST critical requirement a patient must meet prior to extubation?
During the extubation procedure, at what point should the endotracheal tube be gently removed?
During the extubation procedure, at what point should the endotracheal tube be gently removed?
Following extubation, which intervention is important for pulmonary hygiene?
Following extubation, which intervention is important for pulmonary hygiene?
What is a potential complication associated with endotracheal intubation?
What is a potential complication associated with endotracheal intubation?
Which device represents a supraglottic airway?
Which device represents a supraglottic airway?
What advantage does an LMA (Laryngeal Mask Airway) offer over bag-valve-mask ventilation?
What advantage does an LMA (Laryngeal Mask Airway) offer over bag-valve-mask ventilation?
What is a key feature of the Combitube?
What is a key feature of the Combitube?
A 60-year-old male is intubated. What is the typical range for the length of the endotracheal tube (in cm)?
A 60-year-old male is intubated. What is the typical range for the length of the endotracheal tube (in cm)?
In the context of end-tidal CO2 monitoring, what does a color change to 'yellow' typically indicate?
In the context of end-tidal CO2 monitoring, what does a color change to 'yellow' typically indicate?
What device is used for emergency manual ventilation?
What device is used for emergency manual ventilation?
What range (in cmH2O) is considered appropriate when using a cuff manometer?
What range (in cmH2O) is considered appropriate when using a cuff manometer?
What is administered during rapid sequence intubation?
What is administered during rapid sequence intubation?
Following intubation, what areas should you auscultate?
Following intubation, what areas should you auscultate?
Which of the following is recommended as confirmation of tracheal tube position?
Which of the following is recommended as confirmation of tracheal tube position?
For most adults, what catheter size (in French) is the appropriate size for suctioning?
For most adults, what catheter size (in French) is the appropriate size for suctioning?
When was the laryngeal mask airway first in use?
When was the laryngeal mask airway first in use?
True or False: The Combitube requires neck movement for proper insertion.
True or False: The Combitube requires neck movement for proper insertion.
Which of the following is the MOST life-threatening complication if undetected after extubation, frequently associated with vocal cord paralysis?
Which of the following is the MOST life-threatening complication if undetected after extubation, frequently associated with vocal cord paralysis?
Flashcards
Oral Airways
Oral Airways
Airways used to maintain an open passage in the oral cavity.
Nasopharyngeal Airway
Nasopharyngeal Airway
A device inserted through the nose to maintain an open airway.
Endotracheal Tube (ETT)
Endotracheal Tube (ETT)
A semi-rigid tube for airway patency, curved and cuffed.
ETT Size
ETT Size
Signup and view all the flashcards
End Tidal CO2 Monitoring
End Tidal CO2 Monitoring
Signup and view all the flashcards
Post-Intubation Assessment
Post-Intubation Assessment
Signup and view all the flashcards
DOPE mnemonic
DOPE mnemonic
Signup and view all the flashcards
Extubation
Extubation
Signup and view all the flashcards
Extubation Requirements
Extubation Requirements
Signup and view all the flashcards
Extubation Procedure
Extubation Procedure
Signup and view all the flashcards
Post Extubation Follow Up
Post Extubation Follow Up
Signup and view all the flashcards
Laryngeal Mask Airway (LMA)
Laryngeal Mask Airway (LMA)
Signup and view all the flashcards
Combitube
Combitube
Signup and view all the flashcards
Study Notes
- Airways and their management are crucial in medical care.
Oral and Nasopharyngeal Airways
- Oropharyngeal airways are inserted into the mouth.
- Nasopharyngeal airways are inserted into the nose.
Endotracheal Tube (ETT)
- A semi-rigid radiopaque tube is a temporary measure for airway patency.
- Tubes are curved and have a cuff (balloon).
- Size depends on patient size and whether it is placed nasally or orally.
- Recommended internal diameter for adult females is 7.5-8.0 mm, with a length of 19-24 cm.
- Recommended internal diameter for adult males is 8.0-9.0 mm, with a length of 20-28 cm.
ETT Components
- Soft-cuffed ET tube, stylet, and cuff (deflated) are all part of the ETT.
- Pediatric tubes can be cuffed or uncuffed.
- Adult tubes are typically cuffed.
Securing Artificial Airways
- Artificial airways need to be secured properly to maintain placement.
Supportive Equipment
- A 14 French suction catheter is the appropriate size for most adults.
- For children, suction catheter size ranges from 6 Fr (small diameter) to 10 Fr (larger diameter).
- A resuscitation bag (BVM/ambu bag) is used for emergency manual ventilation.
- It should be connected to high-flow supplemental oxygen.
- Oral Pharyngeal Airway or Bite Block
- Manual Resuscitation Bag
Cuff Manometer
- The cuff manometer is used to measure cuff pressure, which should be maintained at 20-30 cmH2O.
Rapid Sequence Intubation
- Rapid sequence intubation involves administering sedation, paralytics, and other medications.
- It's important to talk in reassuring tones to the client.
- Vital signs, including ECG, should be monitored.
- Auscultate for breath sounds bilaterally.
Post-Intubation Assessment
- Auscultate over both lung fields and the epigastric area.
- Carbon Dioxide Monitors (Capnography, End Tidal C02 monitoring)
- Check O2 saturation if there is a perfusing rhythm.
- Obtain a STAT chest X-ray to verify placement.
- Arterial blood gases (ABGs) may be ordered.
End Tidal C02 Monitoring
- Exhaled CO2 (capnography or colorimetry) is recommended to confirm tracheal tube position.
- The membrane in a colorimetric device can turn 'yellow' when end-tidal CO2 is > 2%.
Post Intubation Monitoring Complications (DOPE)
- Displacement of the tube.
- Obstruction of the tube.
- Pneumothorax.
- Equipment failure.
Extubation
- Extubation is the removal of the artificial airway.
- Requirements: Clients must be able to maintain their own airway, have a swallow & gag reflex in tact, cough to remove ones own secretions, and have proper pulminary functions.
Extubation Procedure
- Have O2 and supplies to emergently re-intubate standing by
- Suction ETT and oral cavity thoroughly
- Remove/loosen protective holder
- Deflate cuff completely
- Pull endotracheal tube gently and without pausing at peak of inspiration (so secretions can be coughed out with expiration)
Post Extubation Follow-up
- Involves pulmonary hygiene.
- Includes coughing, deep breathing, and incentive spirometry.
- Aerosol therapy and percussion/postural drainage may be used.
- Noninvasive ventilation.
- There is a risk for Swallowing Dysfunction-vocal cord dysfunction/paralysis as it is a potential complication of ETT
Other Airway Management Devices
- LMA
- CombiTube
Laryngeal Mask Airway (LMA)
- The laryngeal mask airway (LMA) is a supraglottic airway device that has been in use since 1988.
- It is a good alternative to bag-valve-mask ventilation, freeing the hands of the provider and reduces the risk of gastric distention.
Combitube
- The esophageal & tracheal combitube (Combitube™) is a two-barreled tube that functions well when placed in either the trachea or the esophagus.
- Insertion does not require neck movement.
- The large balloon is inflated in the posterior pharynx, and the distal balloon is then inflated.
- It is designed for use in emergency situations and difficult airways.
- It can be inserted without visualization into the oropharynx, and typically enters the esophagus.
- It has a low volume inflatable distal cuff and a much larger proximal cuff designed to occlude the oro- and nasopharynx.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
