DAANCE Module 4
Purpose of the scavenging system - ANSWER Reducing the levels of the noxious
agents to an acceptably low level by exhausting them
... [Show More] 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
Ventilations can be monitored continuously by - ANSWER Auscultation in the
precordial or pretracheal region
observation of the rebreathing bag [Show Less]