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trach and cuffs

what is a stylet used for

guide ET tube

How often does a pt need to be suctioned

PRN(as needed)
*no longer than 15 seconds*
*suction, re-mask, give a few minutes, listen to BS, if need to be suctioned again repeat*

major complications associated with extubation

trach damage
airway obstruction or stridor
difficult breathing
not ready to extubate
vocal card damage
necrosis or fistula (sore)
nose bleeds

what happens to oxygenation level of pt during suction and how to prevent it

o2 levels decrease
pre oxygenation to prevent

what are absolute contraindication for nasotracheal suction

epiglottitis (all ready swollen)

what size of suction catheter for an airway should be used and what would happen if a too large catheter was used

1/2 the size
to big--block air, pneumo, atelectasis

vagal stimultion during suction causes what

bradycardia (slow heart beat)
cardiac arrest

2 different types of laryngoscope blades

miller--straight--lifting epiglottis directly
macintosh--curved--lifting epiglottis indirectly

why is epiglottis a contraindication to the use of a laryngoscope

causes swelling or airway closure

the first and simplest technique use to confirm ET tube placement following intubation

BS 1st
other--chest rise

what is the indications for artificial airway

protect airway
relieve airway obstruction
facilitate suctioning
protect from aspiration
provide closed and sealed system for mechanical vent and CPAP

name 2 types of oropharyngeal airway and there indication and care

Gudell--hole in middle
establish airway
bite blocks for seizing pt
provide suctioning
bite block with ET tube placement
use with mask/bag unit for manual ventilation
poorly tolerated by conscious pt's--gag reflex

describe difference between the oral and nasal airway

oral--provides an airway for emergency situations
short term-24 hours or less
used for mech vent or CPAP--facilitates suctioning
Nasal--used to protect airway from aspiration and provide an airway for mech vent or CPAP--facilitate suctioning via a direct route--best used for longer intubation times-72 hours or more

early and late complications following the placement of a tracheostomy tube

Early Late
bleeding infection
pnuemo humidifiction
sub q stenosis
air embolism hemorrhage
dysfuction of swallowing


minimul leak technique
hear leak at peak inspiration
use during low or no PEEP

hazards of oral intubation

trach damage
right mainstem intubtion
cuff rupture
vocal cord damage
increased risk of infection
intubation of esophagus
broken teeth
vagal stimulation--causes decrease HR-hypertensive

what should the NIF/MIP be before wening a pt from an oral airway

-20 or above

describe the first thing done following intubation of the airway

asses placement

describe the difference between the following terms, tracheostomy, tracheotomy and stoma

tracheostomy--surgical procedure
tracheotomy-- tube

describe posey cufflator nd explain its use

measure actual presurein the cuff
measures in cmH20
has bulbous end to add air and release button to extract air

function and care of a nasopharyngeal airway

relieve upper aireway obstruction caused by tongue or soft palate
facilitates nasal suctioning
provides an airway
bettwer for conscious pt's with an active gag reflex
alternte nares every 8-24 hours
blocks drainage of sinus
place with lube- ky jelly gently insert along floor of nose
measure from tip of nare to tip of ear

parts of endotracheal tube

pilot line-balloon
tracheostomy ties
inner cannula
15-22 mm adapter,
radio opaque line
beveled edge
murphy's eye
placement markings

ideal position for pt for extubation

sit up

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