DAANCE module 5
Hypoxia - ✔✔Deficiency of oxygen
Can result in cardiac dysrhythmia, cardiac arrest, neurologic or brain damage, and ultimately death
Will occur more rapidly in children secondary to a diminished respiratory reserve
Signs of an airway obstruction and treatment - ✔✔choking, gagging, suprasternal notch retraction,
labored breathing and rapid pulse initially followed by decreased pulse, respiratory arrest and cardiac
arrest
TX:
1. 100% O2
2. Trendelenburg position/pack off the surgical site
3. Digital traction of the tongue with gauze, tongue forceps, hemostat or tongue suture
4. Suction oropharynx
If the tongue continues to fall back
5. nasopharyngeal airway in conscious/semiconscous patient
6. oropharyngeal airway for unconscous
7. Consider using LMA or other supraglottic airway
8. Endotracheal tube
Cricothyrotomy - ✔✔Only used when all other methods have failed.
Quickest, easiest way for surgical airway
Made between the thin cricothyroid membrane between the cricoid and thyroid cartilages of the larynx.
TX:
a. cleanse overlying skin
b. locate cricothyroid membrane by palpation
c. utilize the emergency cricothyrotomy needle/ cannula or large gauge to enter the trachea beneath the
vocal cords through the cricothyroid membrane
d. attach the tube of the crycothyrotomy device to an oxygen source such as an anesthesia machine or
ambu bag and ventilate 100% O2
, Tracheostomy - ✔✔Surgical airway below the level of the larynx into the trachea. Usually performed in a
hospital setting
Laryngospasm.. what, prevention and how to fix - ✔✔WHAT?
Protective relfex of the vocal cords
Crowing sounds and labored respiratory efforts
Characterized by cessation of crowing sounds, suprasternal retraction and paradoxical chest movement
("rocking" pattern of the chest and abdomen)
Prevention:
Proper pack placement or throat partition, changing packs and partitions when necessary, adequate
suctioning, control of secretions and adequate anesthesia levels.
TX:
a. 100% O2
b. proper head position/maintain airway
c. pack off surgical site
d. suction oral cavity and oropharynx with tonsil suction
e. postive pressure-100% O2 w/mask
f. administer Succs until spontaneous respiration has resumed.
Succinylcholine - ✔✔Can trigger MH
Can lead to bradycardia in peds patients
In children, atropine should be administered concomitantly with succinylcholine to prevent bradycardia
and life threatening dysrhythmias
May cause cessation of breathing
Bronchospasm. WHAT? TX? - ✔✔Contraction of the smooth muscles of the small bronchi and
bronchioles. Restriction of air to and from the lungs. More difficult expiration than inspiration. Exhibits
Hypoxia - ✔✔Deficiency of oxygen
Can result in cardiac dysrhythmia, cardiac arrest, neurologic or brain damage, and ultimately death
Will occur more rapidly in children secondary to a diminished respiratory reserve
Signs of an airway obstruction and treatment - ✔✔choking, gagging, suprasternal notch retraction,
labored breathing and rapid pulse initially followed by decreased pulse, respiratory arrest and cardiac
arrest
TX:
1. 100% O2
2. Trendelenburg position/pack off the surgical site
3. Digital traction of the tongue with gauze, tongue forceps, hemostat or tongue suture
4. Suction oropharynx
If the tongue continues to fall back
5. nasopharyngeal airway in conscious/semiconscous patient
6. oropharyngeal airway for unconscous
7. Consider using LMA or other supraglottic airway
8. Endotracheal tube
Cricothyrotomy - ✔✔Only used when all other methods have failed.
Quickest, easiest way for surgical airway
Made between the thin cricothyroid membrane between the cricoid and thyroid cartilages of the larynx.
TX:
a. cleanse overlying skin
b. locate cricothyroid membrane by palpation
c. utilize the emergency cricothyrotomy needle/ cannula or large gauge to enter the trachea beneath the
vocal cords through the cricothyroid membrane
d. attach the tube of the crycothyrotomy device to an oxygen source such as an anesthesia machine or
ambu bag and ventilate 100% O2
, Tracheostomy - ✔✔Surgical airway below the level of the larynx into the trachea. Usually performed in a
hospital setting
Laryngospasm.. what, prevention and how to fix - ✔✔WHAT?
Protective relfex of the vocal cords
Crowing sounds and labored respiratory efforts
Characterized by cessation of crowing sounds, suprasternal retraction and paradoxical chest movement
("rocking" pattern of the chest and abdomen)
Prevention:
Proper pack placement or throat partition, changing packs and partitions when necessary, adequate
suctioning, control of secretions and adequate anesthesia levels.
TX:
a. 100% O2
b. proper head position/maintain airway
c. pack off surgical site
d. suction oral cavity and oropharynx with tonsil suction
e. postive pressure-100% O2 w/mask
f. administer Succs until spontaneous respiration has resumed.
Succinylcholine - ✔✔Can trigger MH
Can lead to bradycardia in peds patients
In children, atropine should be administered concomitantly with succinylcholine to prevent bradycardia
and life threatening dysrhythmias
May cause cessation of breathing
Bronchospasm. WHAT? TX? - ✔✔Contraction of the smooth muscles of the small bronchi and
bronchioles. Restriction of air to and from the lungs. More difficult expiration than inspiration. Exhibits
