Emergency Airway Management Basics

Questions and Answers

What is the correct order of primary assessments in emergency care?

Airway, Breathing, Circulation, Disability, Exposure (correct)

Circulation, Airway, Breathing, Exposure, Disability

Exposure, Disability, Circulation, Airway, Breathing

Breathing, Airway, Circulation, Disability, Exposure

The jaw thrust maneuver should be performed without any cervical protection.

False

What should be administered if a patient shows signs of poisoning?

call poison control

A maximum flow rate of _____ L is associated with High-Flow Oxygen (HF).

60 Signup and view all the answers

Match the following emergency conditions with their respective treatments:

Decreased volume = IV fluids bolus Tension pneumothorax = Needle decompression Myocardial Infarction (MI) = Aspirin therapy Tamponade = Fluid resuscitation Signup and view all the answers

What should be done first when managing a patient after an airway obstruction due to potential poisoning?

Call poison control Signup and view all the answers

When using the head tilt/chin lift maneuver, it is always safe to assume cervical protection is not necessary.

False Signup and view all the answers

What are the two main causes categorized under 'H's' in cases of cardiac arrest?

Decreased volume and Increased Potassium Signup and view all the answers

To maintain a safe environment during exposure, it is important to prevent _____ temperature.

decreased Signup and view all the answers

Match the following oxygen delivery methods with their flow rates:

NC = 1-6 L Venturi = 6-10 L HF = 60 L NR = 10-15 L at 100% Signup and view all the answers

Which of the following options are not recommended treatments for snake bites?

All of the above Signup and view all the answers

In case of arrest, CPR and _______ should be initiated ASAP.

Defib Signup and view all the answers

What is the expected laboratory finding in a patient with hypernatremia?

Increased specific gravity Signup and view all the answers

A patient exhibiting confusion and seizure precautions has a serum sodium level of less than 135 mEq/L. What condition does this indicate?

Hyponatremia Signup and view all the answers

What electrocardiogram changes might be seen in a patient with hypokalemia?

Flat T waves Signup and view all the answers

A patient presents with muscle cramps and tingling sensations. The lab results show a calcium level of less than 9.0 mg/dL. Which condition is most likely?

Hypocalcemia Signup and view all the answers

What is a potential consequence of magnesium levels exceeding 2.1 mg/dL?

Decreased heart rate Signup and view all the answers

Which intravenous solution is indicated for treating hypernatremia?

0.45% NS Signup and view all the answers

A patient has been diagnosed with fluid overload. Which of the following symptoms would you expect to find?

Bounding pulse Signup and view all the answers

In cases of severe dehydration, which lab value is most likely to be increased?

Serum osmolality Signup and view all the answers

Which of the following findings is most consistent with hyperkalemia?

Weakness and cramping Signup and view all the answers

What symptom would be expected in a patient with hypomagnesemia?

Increased deep tendon reflexes Signup and view all the answers

What clinical sign is indicative of tension pneumothorax?

Tracheal deviation to the unaffected side Signup and view all the answers

What is the primary purpose of inserting a chest tube?

To reinflate the lung with negative pressure Signup and view all the answers

What does continuous bubbling in a chest tube drainage system typically indicate?

Air leak in the drainage system Signup and view all the answers

Which assessment finding is consistent with flail chest?

Paradoxical respiratory movement Signup and view all the answers

What immediate action should be taken if a chest tube becomes dislodged?

Cover the site with two petroleum gauzes Signup and view all the answers

In maintaining a chest tube, what is crucial to avoid during patient care?

Clamping the chest tube Signup and view all the answers

What should be done if the chest tube drainage system is overturned?

Have the patient cough, exhale, and place it in sterile water Signup and view all the answers

What should be monitored in a patient with a chest tube regarding fluid drainage?

Large volume of bright red fluid early on Signup and view all the answers

What indicates a tension pneumothorax based on physical examination findings?

Tracheal deviation towards the unaffected side Signup and view all the answers

In which situation is a patient at higher risk for flail chest?

Experiencing a motor vehicle accident (MVA) Signup and view all the answers

What is the primary mechanism of action for a chest tube in lung reinflation?

Creating negative pressure in the pleural space Signup and view all the answers

What does the presence of continuous bubbling in a chest tube drainage system indicate?

An air leak in the system Signup and view all the answers

Which nursing intervention is critical to perform while caring for a patient with a chest tube?

Encourage frequent coughing and deep breathing Signup and view all the answers

What is the expected drainage pattern in the first hour after chest tube insertion?

200 cc of bright red fluid Signup and view all the answers

What assessment finding would be common in a patient experiencing paradoxical respiratory movements?

Asymmetrical chest expansion during inhalation Signup and view all the answers

What post-removal instruction should be given to a patient to prevent complications during the procedure?

Instruct the patient to bear down Signup and view all the answers

Study Notes

Emergency Airway Management

Key techniques include head tilt/chin lift and jaw thrust for cervical spine protection.
Assess gag reflex to determine the need for advanced airway management.
Inspect back for potential injuries; remove the cause of injury immediately.
Prevent hypothermia with warm blankets and intravenous (IV) fluid bolus.

Poisoning Response

Contact poison control if poisoned; utilize lavage or activated charcoal for treatment.
Nasogastric (NG) tube placement should be avoided in patients with facial or skull fractures.
Oropharyngeal (OP) airway use is contraindicated if there is a present gag reflex.
Endotracheal (ET) intubation may be necessary in advanced airway management.

Breathing Assessment

Monitor rate, rhythm, and effort of breathing along with oxygen saturation (spO2 %) through auscultation.
Follow the sequence of Airway, Breathing, Circulation, Disability, Exposure, Environment (ABCDE) for assessments.

Oxygen Delivery Methods

Nasal Cannula (NC): delivers 1-6 liters of oxygen.
Venturi mask provides specific oxygen concentrations.
Simple mask: delivers 6-10 liters of oxygen.
High-Flow (HF) mask can provide up to 60 liters.
Non-Rebreather (NR) mask: 10-15 liters at 100% oxygen.

Causes of Cardiac Arrest

H's: Hypovolemia, hyper/hypokalemia, hypercapnia (increased H+), hypoxia (decreased O2), hypothermia (decreased temp), hypoglycemia (decreased sugar).
T's: Toxins, cardiac tamponade, tension pneumothorax, thrombosis causing myocardial infarction (MI) or pulmonary embolism (PE).

Circulatory Assessment

Monitor heart rate (HR), rhythm, blood pressure (BP), and pulse strength distally.
Check capillary refill time in the most distal extremities.
Initiate CPR and defibrillation immediately if cardiac arrest occurs.

Disability and Neurological Assessment

Assess level of consciousness (LOC) using the Glasgow Coma Scale.
Rapid triage of conditions includes resuscitation for arrests, emergent treatment for life/limb-threatening conditions (e.g., shortness of breath, neurological emergencies, significant blood loss, angina), urgent care that requires timely attention, semi-urgent that can wait, and non-urgent cases that are not life-threatening.

Management of Snake Bites

Do not apply ice, corticosteroids, or tourniquets in the management of snake bites.

Emergency Airway Management

Key techniques include head tilt/chin lift and jaw thrust for cervical spine protection.
Assess gag reflex to determine the need for advanced airway management.
Inspect back for potential injuries; remove the cause of injury immediately.
Prevent hypothermia with warm blankets and intravenous (IV) fluid bolus.

Poisoning Response

Contact poison control if poisoned; utilize lavage or activated charcoal for treatment.
Nasogastric (NG) tube placement should be avoided in patients with facial or skull fractures.
Oropharyngeal (OP) airway use is contraindicated if there is a present gag reflex.
Endotracheal (ET) intubation may be necessary in advanced airway management.

Breathing Assessment

Monitor rate, rhythm, and effort of breathing along with oxygen saturation (spO2 %) through auscultation.
Follow the sequence of Airway, Breathing, Circulation, Disability, Exposure, Environment (ABCDE) for assessments.

Oxygen Delivery Methods

Nasal Cannula (NC): delivers 1-6 liters of oxygen.
Venturi mask provides specific oxygen concentrations.
Simple mask: delivers 6-10 liters of oxygen.
High-Flow (HF) mask can provide up to 60 liters.
Non-Rebreather (NR) mask: 10-15 liters at 100% oxygen.

Causes of Cardiac Arrest

H's: Hypovolemia, hyper/hypokalemia, hypercapnia (increased H+), hypoxia (decreased O2), hypothermia (decreased temp), hypoglycemia (decreased sugar).
T's: Toxins, cardiac tamponade, tension pneumothorax, thrombosis causing myocardial infarction (MI) or pulmonary embolism (PE).

Circulatory Assessment

Monitor heart rate (HR), rhythm, blood pressure (BP), and pulse strength distally.
Check capillary refill time in the most distal extremities.
Initiate CPR and defibrillation immediately if cardiac arrest occurs.

Disability and Neurological Assessment

Assess level of consciousness (LOC) using the Glasgow Coma Scale.
Rapid triage of conditions includes resuscitation for arrests, emergent treatment for life/limb-threatening conditions (e.g., shortness of breath, neurological emergencies, significant blood loss, angina), urgent care that requires timely attention, semi-urgent that can wait, and non-urgent cases that are not life-threatening.

Management of Snake Bites

Do not apply ice, corticosteroids, or tourniquets in the management of snake bites.

Electrolytes and Fluid Balance

Electrolytes: Essential for nerve function, muscle contraction, hydration, and pH balance.
Hypo and Hyper states:
- Hypo: Cells swell, conditions like hyponatremia (sodium <135) occur, leading to seizure precautions.
- Hyper: Cells shrink, associated with hypernatremia (sodium >145), causing restlessness and anxiety.

Fluid Solutions

0.45% NS (Hypotonic): Used for providing free water and treats hypernatremia.
0.9% NS (Isotonic): Commonly administered for fluid resuscitation in burns, blood loss, and dehydration.
3% NS (Hypertonic): Used cautiously in severe hyponatremia to pull water out of cells.
D5W/NS: Considered isotonic with calories for energy.

Fluid Imbalance

Dehydration Signs:
- Increased BUN, hematocrit (Hct), specific gravity (SG), hemoglobin (Hgb) levels.
- Symptoms: Weak pulse, dry mucous membranes, poor skin turgor, amber urine, decreased urine output (UO).
Fluid Overload Signs:
- Decreased BUN, Hct, SG, Hgb levels, with symptoms like bounding pulse, increased blood pressure (BP).

Sodium (Na)

Hypernatremia: Sodium >145, causing thirst, increased BP/HR, and seizure precautions.
Hyponatremia: Sodium <135, fosters confusion, headache, N/V, and also requires seizure precautions.

Potassium (K)

Hyperkalemia: Levels >5.0. Monitoring essential due to cardiac risks, facilitating GI cramps, and fluctuations in kidney output.
- EKG changes: Tall T waves, prolonged PR interval, wide QRS, absent P wave.
Hypokalemia: Levels <3.5. Strain on cardiac function comes with low BP, weak pulses, and increased GI motility.

Calcium (Ca)

Hypercalcemia: Levels >10.5. Symptoms include bone pain, weakness, increased urine output, risk for kidney stones.
Hypocalcemia: Levels <9.0, signaling potential seizure issues. Symptoms like numbness, tingling, cramps, and weakness appear.

Magnesium (Mg)

Hypermagnesemia: Levels >2.1. Causes include low BP, decreased respiratory rate, and lethargy; associated with chronic kidney disease (CKD).
Hypomagnesemia: Levels <1.3, characterized by increased DTRs, mental changes, and needs cardiac monitoring for possible arrhythmias.

Risk Factors and Management

Furosemide Use: A diuretic linked to multiple electrolyte disturbances, essential for regulating fluid volume and preventing overload.
Clinical Monitoring: Essential for maintaining electrolyte balances; EKG, vital signs, and urine output should be routinely assessed based on electrolyte levels.

Pneumothorax

Pneumothorax refers to the presence of air in the pleural space.
Tension pneumothorax causes tracheal deviation towards the unaffected side.
Treatment for tension pneumothorax involves needle decompression.
Risk factors include trauma, which can be life-threatening.

Signs and Symptoms

Common symptoms include anxiety, pain during respiration, and respiratory distress.
Typically characterized by decreased breath sounds and asymmetric respiratory rates.

Flail Chest

Occurs due to rib fractures, typically from CPR or motor vehicle accidents (MVAs).
Presents with paradoxical respiratory motion (inward movement of the chest during inspiration).
Diagnosis is confirmed through a chest X-ray.

Chest Tube Management

Chest tubes reinflate the lung by creating negative pressure.
Systems often consist of three chambers: drainage, water seal, and suction.
Initial drainage of 200 cc during the first hour, followed by 100 cc/hour is normal.
Drainage color change: bright red indicates fresh blood, dark red indicates older blood.

Observations and Maintenance

Continuous bubbling in the water seal chamber indicates an air leak.
Tidaling reflects respiratory movements; rises and falls with inhalation and exhalation.
Avoid clamping the chest tube to prevent complications.

Positioning and Care

Position the head of the bed at 30-45 degrees to facilitate lung expansion.
Keep the chest tube below the level of the chest to ensure proper drainage.
Regular lung assessments every 4 hours are necessary.
Encourage deep breathing and coughing to promote lung re-expansion.

Emergency Procedures

If the chest tube does not drain, it may need to be replaced; notify healthcare provider.
In case of tube dislodgement, cover the site with two layers of petroleum gauze to prevent pneumothorax.
For a tube that has overturned, have the patient cough and exhale, then place the tube in sterile water.

Additional Care Instructions

Maintain sterile technique, using iodine for cleaning as necessary.
Regularly assess for subcutaneous emphysema and crepitus at the site.
Avoid "milking" or "stripping" to prevent increased intrathoracic pressure.
Perform incentive spirometry for 10 breaths while awake to encourage deep breathing.
Ensure sterile water is available at the bedside for emergencies.

Pneumothorax

Pneumothorax refers to the presence of air in the pleural space.
Tension pneumothorax causes tracheal deviation towards the unaffected side.
Treatment for tension pneumothorax involves needle decompression.
Risk factors include trauma, which can be life-threatening.

Signs and Symptoms

Common symptoms include anxiety, pain during respiration, and respiratory distress.
Typically characterized by decreased breath sounds and asymmetric respiratory rates.

Flail Chest

Occurs due to rib fractures, typically from CPR or motor vehicle accidents (MVAs).
Presents with paradoxical respiratory motion (inward movement of the chest during inspiration).
Diagnosis is confirmed through a chest X-ray.

Chest Tube Management

Chest tubes reinflate the lung by creating negative pressure.
Systems often consist of three chambers: drainage, water seal, and suction.
Initial drainage of 200 cc during the first hour, followed by 100 cc/hour is normal.
Drainage color change: bright red indicates fresh blood, dark red indicates older blood.

Observations and Maintenance

Continuous bubbling in the water seal chamber indicates an air leak.
Tidaling reflects respiratory movements; rises and falls with inhalation and exhalation.
Avoid clamping the chest tube to prevent complications.

Positioning and Care

Position the head of the bed at 30-45 degrees to facilitate lung expansion.
Keep the chest tube below the level of the chest to ensure proper drainage.
Regular lung assessments every 4 hours are necessary.
Encourage deep breathing and coughing to promote lung re-expansion.

Emergency Procedures

If the chest tube does not drain, it may need to be replaced; notify healthcare provider.
In case of tube dislodgement, cover the site with two layers of petroleum gauze to prevent pneumothorax.
For a tube that has overturned, have the patient cough and exhale, then place the tube in sterile water.

Additional Care Instructions

Maintain sterile technique, using iodine for cleaning as necessary.
Regularly assess for subcutaneous emphysema and crepitus at the site.
Avoid "milking" or "stripping" to prevent increased intrathoracic pressure.
Perform incentive spirometry for 10 breaths while awake to encourage deep breathing.
Ensure sterile water is available at the bedside for emergencies.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz focuses on essential practices for emergency airway management, including techniques like head tilt/chin lift and jaw thrust. It also covers assessment of breathing and circulation, as well as identifying and addressing potential injuries and environmental factors. Test your knowledge on life-saving protocols and interventions.