DAANCE Module 4 exam with complete solution!!

Purpose of the scavenging system - Reducing the levels of the noxious agents to an acceptably low level by exhausting them outside the operating room. Medical gas cylinder colors - Blue- Nitrous Oxide Green- Oxygen Yellow- Compressed Air Brown- Helium Black- Nitrogen Gray- Carbon Dioxide Airway Adjuncts(8) - Head-tilt/Chin-lift Tongue traction suture Nasopharyngeal airway Oropharyngeal airway Laryngeal mask airway I-gel supraglottic airway Endotracheal tube Combitube Cricothyrotomy Tongue traction suture - When the tongue is obstructing the airway one or two sutures can be placed through the dorsum of the tongue and grasped with a large hemostat Nasopharyngeal airway - Does not interfere with procedures Well-tolerated Can be used on awake patients Passed through one of the nostrils into the nasal cavity into the oropharynx posterior to the tongue. Oropharyngeal airway - Oral airway may be used to position the tongue in a more anterior position interferes with intraoral procedures not tolerated well in awake patients Supraglottic airway - Placed above the level of the vocal cords 2 types: laryngeal mask airway (LMA) and I-gel supraglottic airway Gastric port or small tube that passes through the length of the airway to allow access for a suction catheter that can by used to remove fluid in the stomach and diminish likelihood of aspiration of acidic gastric juices. Laryngeal mask airway (LMA) - Plastic tube at the end of which is a small air inflated balloon that sits tightly over the top of the larynx. Advantage: may be placed blindly without the use of a laryngoscope. Does NOT protect the airway from the aspiration of regurgitated material. Follows the natural bend of the oropharynxa nd comes to rest over the larynx. →cuff is then inflated I-gel Supraglottic airway - Similiar to LMA, however, balloon is filled with gel rather than air, which enables the mask to adapt closely to the tissues surrounding the larynx and does not require inflation. These airways can be rapidly inserted, and they are less likely to become dislodged. Endotracheal Tubes - May be placed blindly orally, nasally or in tracheostomy site End of the tube passes through the vocal cords, after which it is advanced to terminate halfway between the vocal cords and bifurcation of the trachea. Important to auscultate the left and right side of the chest as well as the stomach. Breath sounds should be heard on both sides of the chest Combitube - Reserved for significant emergencies Can be placed blindly It will ordinarily (80%) of the time end up in the esophagus after blind placement. Both cuffs are inflated, can be ventilated through the esophagus or trachea Cricothyrotomy - Quickest and easiest surgical airway. Accomplished by making an opening through the thin membrane between the cricoid and thyroid cartilages of the larynx. Defibrulator - 2 types: Full function or AED Full function defibrulator - Paddles/pads can deliver electrical charges to the patient. Counter-shock is measured in joules. Only practical definitive treatment for V-fib AED - Automatically assess cardiac rhythm Semi-automatic type- device assess the rhythm and if a shock is advised, it instructs the operator to deliver. Automatic type-AED assesses the presence of V-fib and then automatically delivers the recommended shock on its own. Most are biphasic- discharge or shock in two directions across the chest. Maintenance: testing of paddles, checking and replacing pads Cardiac monitor - Determines arterial pressure Adult cuff of a child will result in a low bp Cuff needs to be sufficiently wide-should cover 2/3 the distance from the elbow to the shoulder. 80-100% circumference of the arm Respiratory ventilation - Observation: chest rise- easiest