DAANCE module 5
What is hypoxia? - ✔✔lack of oxygen
what is the cause of complete or partial airway obstruction during anesthesia? - ✔✔posterior positioning
of the tongue
what are signs of airway obstruction? - ✔✔choking, gagging, suprasternal notch retraction, labored
breathing and rapid pulse followed by decreased pulse, respiratory arrest and cardiac arrest
what is early treatment of airway obstruction? - ✔✔100% oxygen via nasal mask; place patient in
Trendelenburg position and pack off surgical site; Digital traction of the tongue; Suction
how do you do a cricothyrotomy? - ✔✔cleanse the overlying skin; locate the cricothyroid membrane by
palpation; utilize the emergency cricothyrotomy needle/cannula kit or a large gauge to enter the trachea
beneath the vocal cords through the cricothyroid membrane; Attach the tube of the cricothyrotomy
device to an oxygen source and ventilate with 100% oxygen
what object can cause airway obstruction that is not the tongue? - ✔✔foreign bodies
what is the treatment for foreign body obstruction? - ✔✔removal of foreign body only if well visualized;
chest compressions if no airflow during ventilation with patient in supine position; remove foreign body
with forceps or suction using a laryngoscope for visualization; cricothyrotomy only if foreign body cannot
be removed and severe obstruction persists
laryngospasm - ✔✔spasm of the laryngeal muscles, causing a constriction
Laryngospasm Treatment - ✔✔• 100% Oxygen
• Suction all blood and foreign material with yankauer suction
• Pack surgical site to prevent further bleeding into the hypopharynx
• Depress patient's chest and listen for a rush of air to indicate patency
, • If obstruction persists, break spasm with positive pressure via 100% O2 and full-face mask with good
seal (appropriately sized for child vs. adult
patient.)
bronchospasm - ✔✔involuntary contraction of the bronchus
Bronchospasm treatment - ✔✔Albuterol 2 puffs (90 mcg/puff) prn
O2 6-10L/min
If unresponsive to albuterol:
Epinephrine SC (1:1000) 0.1-0.3 mL (0.1-0.3 mg) OR
Epinephrine IV (1:10,000) 1-3 mL (0.1-0.3 mg) (especially if hypotensive)
Up to 1 mg epinephrine maximum
Hyperventilation - ✔✔ventilation of the lungs beyond normal body needs
Angina treatment - ✔✔Sublingual nitroglycerin, treatment of underlying condition
myocardial infarction treatment - ✔✔Aspirin, CPR is unconscious, defibrillation, anticoagulant
medication, immediate emergency protocol
MONA acronym - ✔✔M-morphine
O-oxygen
N-nitrates
A-aspirin
what is the actual order for MONA? - ✔✔O- oxygen
N- nitroglycerin
A- aspirin
What is hypoxia? - ✔✔lack of oxygen
what is the cause of complete or partial airway obstruction during anesthesia? - ✔✔posterior positioning
of the tongue
what are signs of airway obstruction? - ✔✔choking, gagging, suprasternal notch retraction, labored
breathing and rapid pulse followed by decreased pulse, respiratory arrest and cardiac arrest
what is early treatment of airway obstruction? - ✔✔100% oxygen via nasal mask; place patient in
Trendelenburg position and pack off surgical site; Digital traction of the tongue; Suction
how do you do a cricothyrotomy? - ✔✔cleanse the overlying skin; locate the cricothyroid membrane by
palpation; utilize the emergency cricothyrotomy needle/cannula kit or a large gauge to enter the trachea
beneath the vocal cords through the cricothyroid membrane; Attach the tube of the cricothyrotomy
device to an oxygen source and ventilate with 100% oxygen
what object can cause airway obstruction that is not the tongue? - ✔✔foreign bodies
what is the treatment for foreign body obstruction? - ✔✔removal of foreign body only if well visualized;
chest compressions if no airflow during ventilation with patient in supine position; remove foreign body
with forceps or suction using a laryngoscope for visualization; cricothyrotomy only if foreign body cannot
be removed and severe obstruction persists
laryngospasm - ✔✔spasm of the laryngeal muscles, causing a constriction
Laryngospasm Treatment - ✔✔• 100% Oxygen
• Suction all blood and foreign material with yankauer suction
• Pack surgical site to prevent further bleeding into the hypopharynx
• Depress patient's chest and listen for a rush of air to indicate patency
, • If obstruction persists, break spasm with positive pressure via 100% O2 and full-face mask with good
seal (appropriately sized for child vs. adult
patient.)
bronchospasm - ✔✔involuntary contraction of the bronchus
Bronchospasm treatment - ✔✔Albuterol 2 puffs (90 mcg/puff) prn
O2 6-10L/min
If unresponsive to albuterol:
Epinephrine SC (1:1000) 0.1-0.3 mL (0.1-0.3 mg) OR
Epinephrine IV (1:10,000) 1-3 mL (0.1-0.3 mg) (especially if hypotensive)
Up to 1 mg epinephrine maximum
Hyperventilation - ✔✔ventilation of the lungs beyond normal body needs
Angina treatment - ✔✔Sublingual nitroglycerin, treatment of underlying condition
myocardial infarction treatment - ✔✔Aspirin, CPR is unconscious, defibrillation, anticoagulant
medication, immediate emergency protocol
MONA acronym - ✔✔M-morphine
O-oxygen
N-nitrates
A-aspirin
what is the actual order for MONA? - ✔✔O- oxygen
N- nitroglycerin
A- aspirin
