Memorize

Front 1

Adequate mask ventilation

Back 1

NBCx3
NEG gas sounds
BBS
Condensation
CO2
Chest rise

Front 2

Adv to masking

Back 2

SCAR
SORE THROAT, cost, anesthetic depth, relaxants not needed

Front 3

CI for nasal intubation

Back 3

BICE
Basal skull fracture, infection, coags, epistaxis

Front 4

Hazards of mask ventilation

Back 4

Dermatitis/necrosis
Aspiration
Eye edema
Conjunctiva
Blindness
Nerve injury -buccal facial nerve
Corneal abrasion
+ environmental pollution, cervical spine immobility, fatigue

Front 5

Disadv to mask

Back 5

HH DIOR
Hands not free
Higher gas flows
Difficult to maintain airway
Intraop manipulation
O2 desat
Remote access

Front 6

Comps for oral/nasal

Back 6

Airway obstruction or trauma- tongue damage/edema, epistaxis, aspiration, LARYNGOSPASM

Front 7

Indication for ETT and aspiration

Back 7

FITO PEG
Full stomach
Intestinal obstruction
Trauma
Obesity
Preggo
Esophageal reflux
Gastric paresis - diabetes

Front 8

Preop interview

Back 8

FAM - food, anesthesia hx, med hx
ACP-HIDEP
AIRWAY, cardio-pulm
Handicap-physical abnormalities
IV access
Diagnostic tests
Eval
Proceed?

Front 9

Equipment

Back 9

ML SLOTS
M forceps
Laryngoscopes
Suction
Lube
Oxygen/mask/circuit
Tape
Stylet

Front 10

Steps for laryngospasm treatment

Back 10

PLS
Positive pressure w 100% fio2 with mask- check gastric inflation
Larson maneuver at laryngospasm notch - mandible and mastoid process
Succ 0.1 mg/kg
Intubate only if severe hypoxemia or edema

Front 11

Treatment for obstruction

Back 11

CJOP
Call their name
Chin lift
Jaw thrust - lift angle of mandible
Reposition head
Oral airway
Remove foreign body
Mask with positive pressure ventilation
Intubate

Front 12

Deep extubation

Back 12

For those who cant have coughing after procedure.. Asthma, plastic surgeries, hernia repairs

Front 13

CI for LMA

Back 13

HAPS
High pressure requirements
Aspiration risk
Pathology
Surgical field interference

Front 14

Hemodynamic response to intubation

Back 14

Dysrhythmias, htn, tachy, bronchospasm

Front 15

* advan to LMA

Back 15

Less Sore throat, invasive, coughing, trauma, drug needed
Smoother process

Front 16

Intubation disadvantages

Back 16

Perforation, trauma, sore throat, nosebleeds, vocal cord injury, obstruction, dental trauma, aspiration

Front 17

Mendelsons syndrome

Back 17

Gastric content aspiration during induction
ph <2.5 n >25 cc

Front 18

BURP

Back 18

Method to help visualize vocal cords ...
Backward upward rightward pressure of thyroid cartilage

Front 19

Distance from teeth to vocal cords and VC to carina

Back 19

10-15 cm

Front 20

Formula to find depth of tube insertion

Back 20

Age/2 +12 under 12
7-8-9 for babies
23 male 21 female

Front 21

Cuffed and uncuffed tube size

Back 21

Age/4+4 for un cuffed
Age/4+3 cuffed
Kids usually get cuffed now over age 1

Front 22

Reduce gastric volume and increase pH

Back 22

NG tube
Reglan
H2 blocker- ranitidine
Proton pump inhibitor- omeprazole
Anticholinergic- glyco
Antacids-bicitra

Front 23

Me delusions trx

Back 23

Suction
Lateral head down position
Beta agonist- to help mucocilliary fx and clear secretions
No lavage, abx or steroids
Chest xray
Fluids for SIRS / pressors
Bronch

Front 24

Reduce gastric volume and increase pH

Back 24

NG tube
Reglan
H2 blocker- ranitidine
Proton pump inhibitor- omeprazole
Anticholinergic- glyco
Antacids-bicitra

Front 25

Mendelsons trx

Back 25

Suction
Lateral head down position
Beta agonist- to help mucocilliary fx and clear secretions
No lavage, abx or steroids
Chest xray
Fluids for SIRS / pressors
Bronch

Front 26

Causes of laryngospasm

Back 26

IBF2rectum
1. Irritant gases
2. Secretions/blood
3. Foreign bodies
4. Stimulate periosteum, dilation of rectum, celiac plexus
5. Manipulating airway during stage 2
6. Light anesthesia- before or after extubation

Front 27

Cough 3 events

Back 27

1. Deep inspiration
2. Right Glottic closure
3. Expiratory phase

Front 28

Cough 3 events

Back 28

1. Deep inspiration - to build high lung volumes
2. Right Glottic closure - to build pressure of over 100 cm H2O
3. Expiratory phase

Front 29

Laryngospasm is sensed by this nerve

Back 29

Superior laryngeal nerve which innervates vocal cords

Front 30

5 important steps to airway management

Back 30

1. H&P
2. Consider ease of rapid intubation
3. Risk of aspiration
4. Plan for supraglottic ventilation
5. Risk to pt of failed airway maneuvers
HARF

Front 31

Temporary blindness from masking affects this nerve

Back 31

Central retinal artery

Front 32

Tight masks can affect these nerves

Back 32

Buccal branch facial nerve -affects orbicularis oris muscle
Supraorbital
Supratrochlear

Front 33

Purpose of airways

Back 33

Lift tongue and epiglottis away from posterior pharynx
- protect tongue
- prevent biting
- provide path for inserting tubes into esophagus
- help sxning
- obtain better mask fit

Front 34

Causes of airway obstruction

Back 34

Soft tissue
Foreign body
Tumor laryngospasm

Front 35

Awake extubation is mandatory if

Back 35

DEAD
Difficult to mask
Edema
Aspiration risk
Difficult to mask ventilate

Front 36

Awake extubation criteria

Back 36

THORN CORM
TV > 5cc/kg
Hands grasp head lift
O2 sat
RR
NIF >25 cm H2O
CO2 < 50mmHg
Responsive
Muscle relaxants

Front 37

Awake extubation is mandatory if

Back 37

DEAD
Difficult to mask
Edema
Aspiration risk
Difficult to mask ventilate

Front 38

Awake extubation criteria

Back 38

THORN CORM
TV > 5cc/kg
Hands grasp head lift
O2 sat
RR
NIF >25 cm H2O
CO2 < 50mmHg
Responsive
Muscle relaxants

Front 39

Awake Extubation steps

Back 39

1. Correct plane -Responsive pt with spontaneous breaths adequate rate and TV
2. Insert oral airway
3. 100% O2
4. Suction
5. Deflate cuff
6. Remove during inspiration
7. Mask ventilate
8. Check for adequate air exchange
9. Assist in ventilation
10. Monitor for laryngospasm

Front 40

Nasal intubation steps

Back 40

1. Sniffing position
2. Preoxygenate with mask
3. Prepare tube with warm saline and lube
4. Induce general anesthesia
5. Hyperextend neck
6. Insert tube into nares
7. Advance posteriorly
8. Open mouth with scissor technique
9. Insert laryngoscopes into right side of mouth and sweep tongue to the left, locate vallecula, insert tip into vallecula and lift up and away
10. Locate vocal cords
11. Ask for forceps and align ETT up to glottis
12 have assistant advance ETT past the vocal cords
13. Check placement
14. Secure tube

Front 41

Nasal intubation steps

Back 41

1. Sniffing position
2. Preoxygenate with mask
3. Prepare tube with warm saline and lube
4. Induce general anesthesia
Spray
5. Hyperextend neck
6. Insert tube into nares
7. Advance posteriorly
8. Open mouth with scissor technique
9. Insert laryngoscopes into right side of mouth and sweep tongue to the left, locate vallecula, insert tip into vallecula and lift up and away
10. Locate vocal cords
11. Ask for forceps and align ETT up to glottis
12 have assistant advance ETT past the vocal cords
13. Check placement
14. Secure tube

Front 42

Floor intubation steps

Back 42

1. Assess pt, gather info, ventilate, monitors, suction, develop a plan, maybe give sedation
2. Gather supplies - bougie, difficult airway cart and assistant
3. Consider - sedation, topical anesthetic or NMB
4. Intubate and check placement- can use bulb and easy cap 2, o2 sats, get an X-ray
Ballotment

Front 43

Awake fiberoptic intubation steps

Back 43

1. Inform pt of why and procedure, get consent, medicate
2. Gather supplies -suction
3. Nebulizer 4% lidocaine, cetacaine spray or nerve block
4. Place Williams airway
5. Slide Parker flex tip tube over scope and insert into airway
6. Find vocal cords and advance until u see tracheal rings and carina
7. Advance ETT into vocal cords
8. Remove scope
9. Inflate cuff check placement
10. Induce general anesthesia

Front 44

LMA INSERTION

Back 44

1. Deflate cuff
2. Lube on the back
3. Sniffing position
4. Open mouth
5. Hold LMA like a pencil
6. Slide firmly along the hard palate
7. Advance into pharynx until resistance is met
8. Inflate cuff without holding the tube
9. Watch outward neck movement
10. Connect to circuit and check placement
11. Place bite block and secure tube

Front 45

Difficulty in LMA INSERTION

Back 45

1. C spine immobility
2. Limited mouth opening

Front 46

Benefits of masking

Back 46

Minimally invasive
Universal
Requires no sophisticated equipment
Critical to managing airway

Front 47

Components of lar cavity

Back 47

Cords
Rima
Cricoid

Front 48

3 benefits of adult ETT cuffs

Back 48

1. Positive pressure
2. Aspiration prevention
3. Leak proof inhalation of anesthesia

Front 49

Benefits of LMA over intubation

Back 49

CDIF
C
Difficult intubation
Invasive
F