Trauma Nursing Core Course (TNCC) Provider Manual 9th Edition

Trauma Nursing Core Course (TNCC) Provider Manual 9th Edition If an airway is patent, what is the goal? - ansFocusing efforts at maintaining and supporting a patent airway (Pt may be allowed to assume position that facilitates better air exchange so long as no CSI is suspected) Can an oropharyngeal airway be used in someone with a gag reflex? - ansNo How do you assess breathing? - ansExpose the patient's chest and inspect for the following: Spontaneous breathing Symmetrical chest rise and fall Depth, pattern and rate of resps Work of breathing (accessory muscles, pursed lip, diaphragmatic breathing) Skin colour Contusions, abrasions, deformities Open pneumothorax JVD Signs of inhalation injuries Sign of inhalation injuries - ansSinged nasal hairs Carbonaceous sputum Hoarse voice How to assess for proper placement of a definitive airway (3 steps) - ans1. Attach CO2 detector (assess for presence of CO2 after 5-6 breaths) 2. Adequate rise/fall of chest with assisted ventilation 3. Auscultate for gurgling over epigastrium and presence of bilateral breath sounds. What is a result of inadequate oxygenation? - ansHypoxemia Resulting in anaerobic metabolism and acidosis ETCO2 level indicating effective ventilation - ans35-45 mm (Greater than 50 signifies depressed ventilation What is a definitive airway? - ansTube securely placed in the trachea with cuff inflated. Why is alertness included in the airway assessment? - ansIncluding this helps evaluate the patient's ability to protect their own airway What pneumonic is used to assess a patient level of alertness? - ansA: Alert V: Responds to verbal stimuli P: Responds to pain U: Unresponsive suspected) Can an oropharyngeal airway be used in someone with a gag reflex? - ansNo Why is AVPU beneficial to use at the beginning of the initial patient assessment? - ansWill help determine appropriate airway intervention In a patient who is unable to open their mouth or unresponsive, how do we assess the airway? - ansJaw- thrust maneuver is performed to open airway and mouth to assess for obstruction What inspecting the airway, what are we inspecting for? - ansVocalization Tongue Obstruction Loose or missing teeth Foreign objects Fluids (blood, vomit, secretions) Edema Burns/ evidence of inhalation injury What pneumonic is used to assess a patient level of alertness? - ansA: Alert V: Responds to verbal stimuli P: Responds to pain U: Unresponsive Why is AVPU beneficial to use at the beginning of the initial patient assessment? - ansWill help determine appropriate airway intervention