Anticipation of deteriorating course rsi is preferred

Info icon This preview shows pages 2–5. Sign up to view the full content.

Anticipation of deteriorating course RSI is preferred: induction agent is given first: Ketamine, Etomidate promotes unconsciousness Paralytic is then given: Succinycholine, paralytic of choice Rare side effects-->Malignant Hyperthermia Antidote: Dantrolene Pt. is usually unconscious and paralyzed Intubation aids mac-curved blade miller-straight blade bougie-flexible glidescope- visual aid for insertion Sites: typically 7-7.5 for women typically 8-9 for men Oropharyngeal airway: used to maintain or open a pts. airway works by preventing tongue from covering epiglottis measure from corner of mouth to angle of the jaw
Image of page 2

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

3 contraindicated in pts. who have a gag reflex or foreign body Nasopharyngeal airway: can provide an airway in a pt. who has gag reflex facilitate suctioning in pts. who need it measure from the tip of the nose, to the tragus of the ear contraindicated in basal skull injury or nasal fracture, or coagulopathy doesn't protect airway from aspiration Laryngeal mask airway make sure its in place maintains airway without intubation give sedation prior to insertion propofol versed less gastric distention contraindicated in pt. with gag reflex Cricothyrotomy- EMERGENCY used to establish airway when LMA& intubation are ineffective or contraindicated Indications: trauma causing oral, pharyngeal, or nasal hemorrhage facial muscle spasms uncontrollable emesis upper airway emesis clenched teeth tumor causing obstruction anaphylaxis Breathing Nursing assessment: spontaneous breathing equal rise and fall rate and pattern use of accessory muscles skin color integ. of soft tissues and bony structures of chest wall bilateral breath sounds tracheal deviation and JVD are late signs of breathing compromise *Auscultate at the 2 nd intercostal midclavicular and 5 th intercostal anterior axillary line All trauma pts. receive supplemental O2 NRB Assess for signs of ineffective breathing: altered mental status cyanosis, esp. around the mouth asymmetric expansion of chest wall use of accessory or abd. muscles
Image of page 3
4 sucking chest wound absent or diminished breath sounds Lung injuries that comp. breathing pneumothorax Simple results when an injury to the lung leads to accumulation of air in the pleural space w/ a subsequent loss of the neg. intrapleural pressure; total or partial collapse of the lung may ensue. An open pneumo. results from a wound though the chest wall. Air enters the pleural space both through the wound and the trachea. Tape on three sides s/s: dyspnea tachypnea chest pain tachycardia subQ emphysema decreased or absent breath sounds open sucking chest wound on inspiration thin and tall smokers are more at risk Treatment: cover open wound; s/s of tension? Remove dressing and reevaluate; pneumo. >15%
Image of page 4

Info icon This preview has intentionally blurred sections. Sign up to view the full version.

Image of page 5
This is the end of the preview. Sign up to access the rest of the document.
  • Fall '17
  • Pneumothorax, airway obstruction, chest wall

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern