Purpose of the scavenging system - Reducing the levels of the noxious agents to an acceptably low level by exhausting them outside the operating
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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 [Show Less]