UPDATED 2024 DAANCE Module 4 EXAM

Purpose of the scavenging system - ANSWER Reducing the levels of the noxious agents to an acceptably low level by exhausting them outside the operating room. Medical gas cylinder colors - ANSWER Blue- Nitrous Oxide Green- Oxygen Yellow- Compressed Air Brown- Helium Black- Nitrogen Gray- Carbon Dioxide Airway Adjuncts(8) - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER 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) - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER 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 - ANSWER Quickest and easiest surgical airway. Accomplished by making an opening through the thin membrane between the cricoid and thyroid cartilages of the larynx. Defibrulator - ANSWER 2 types: Full function or AED Full function defibrulator - ANSWER Paddles/pads can deliver electrical charges to the patient. Counter-shock is measured in joules. Only practical definitive treatment for V-fib AED - ANSWER 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 - ANSWER 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 - ANSWER Observation: chest rise- easiest Anesthesia bag-inflating and deflating Color- extremely late sign of respiratory problems (hypoxema-insufficient oxygen in the blood) Pretracheal stethoscope sounds - ANSWER Gurgling: Laryngospasm Wheezing: bronchospasm Rumbling: Vomit Pulse ox - ANSWER Measures and displays the level of oxygenated hemoglobin compared with total hemoglobin at the site of the probe Measures pulse rate, the perfusion at the site of the probe, and the oxygenation of the patient by determining the oxygen saturation level of the circulation hemoglobin. Pulse ox measures only the oxygen that is bound to hemoglobin which is displayed as the oxygen saturation percentage. Capnograph - ANSWER Measures the level of carbon dioxide as the patient exhales Monitoring anesthetic depth - ANSWER Changes in vital signs and oxygen saturation. Inadequate: bp, pulse, respiratory rate and depth of respiration tend to increase. Too deep: vital signs and O2 decrease eyelid reflex-reflex is lost when pt is heavily sedated. Stroking the eyelashes will elicit a closing movement of the eyelid as the patient begins to awaken. How often should the function of an anesthesia machine be checked? - ANSWER Daily in the US, the color for a Nitrous oxide cylinder is? - ANSWER Blue Blood pressure levels will most likely be falsely LOW when using - ANSWER an adult cuff on a small child A monitoring device that gives information about both circulation and ventilation is the? - ANSWER Capnograph What are the indicators of partial respiratory obstruction in a sedated patient? - ANSWER Gurgling, snoring, high-pitched crowing or wheezing noted while monitoring with a precordial stethoscope