RT 131 - Artificial Airway Care and Manual Ventilation

1. Demonstrate an understanding of intubation and the equipment required.
   1. Explain the indications for manual ventilation.
   2. Describe the standards for design and construction of manual resuscitators.
   3. Identify the outside and inside diameter of the standard anesthesia “universal connector.”
   4. Identify and explain the function of the following types of “patient valves” during inhalation and exhalation:
      1. Spring disk
      2. Spring ball
      3. Cupped disk
      4. Diaphragm
      5. Diaphragm and duckbill
      6. Diaphragm and leaf valve
   5. Identify and explain the function of the following types of bag “inlet valves” during inhalation and exhalation:
      1. Spring disk
      2. One-way leaf valve
   6. For resuscitators discuss in class identify the:
      1. Type of patient valve
      2. Type of inlet valve
      3. Approximate volume of bag
      4. Maximum suggested oxygen flow rates
      5. Type of oxygen reservoir
      6. Maximum oxygen percentage expected
      7. Type of pressure relief
      8. Capability of spontaneous breathing of increased FI02
      9. Methods of sterilization
      10. Advantages and disadvantages
   7. Explain the variables that determine the delivered FI02 from manual resuscitators.
   8. Explain the function of gas powered resuscitators.
   9. Explain methods to determine the effectiveness of manual ventilation.
   10. Assemble and disassemble a manual resuscitator.
   11. Perform appropriate bag and mask ventilation both one and two hand.
   12. Perform appropriate bag and endotracheal tube ventilation.
2. Demonstrate understanding of knowledge or techniques associated with airways.
   1. Identify major structures of the upper airway
      1. Nose
      2. Oral Cavity
      3. Nasopharnyx
      4. Oropharynx
      5. Hypopharynx
      6. Larynx
   2. Identify and explain primary causes of upper airway obstruction
   3. Identify clinical signs of upper airway obstruction.
   4. Differentiate between various methods to relieve upper airway obstruction, based on clinical signs.
   5. Explain the function and use of the:
      1. Oropharyngeal airway
      2. Nasopharyngeal airway
      3. Esophageal obturator
      4. Pharyngeo-tracheal lumen airway
   6. Explain advantages and disadvantages of the devices listed above.
   7. Define the term “artificial airway.”
   8. Explain the indications for establishment of an artificial airway.
   9. Explain the four major airway protective reflexes.
   10. Explain the hazards of artificial airways.
   11. Describe various techniques for establishing an emergency airway.
   12. Identify and explain the function of a:
       1. Laryngoscope
       2. Straight blade
       3. Curved blade
   13. Demonstrate the appropriate technique for orotracheal intubation.
   14. Explain the post intubation procedures to assess proper tube placement.
   15. Explain the limitations of emergency airways.
   16. Define the term “non-emergency airway.”
   17. Describe techniques for establishing a non-emergency airway.
   18. Explain advantages and disadvantages of nasotracheal intubation.
   19. Identify “immediate complications” of a tracheostomy.
   20. Identify “late complications” of a tracheostomy.
   21. Explain advantages and disadvantages of the various materials found in endotracheal and tracheal devices.
   22. Explain the markings on endotracheal and tracheostomy tubes.
3. Demonstrate an understanding of monitoring cuff pressures with artificial airways.
   1. Give an appropriate rationale for recommending endotracheal intubation vs tracheostomy.
   2. Explain the difference between “contamination” and “infection.”
   3. Explain how the diagnosis of pulmonary infection is made.
   4. Identify common airway contaminants.
   5. Explain the appropriate use of antibiotics to treat pulmonary infection.
   6. Give an appropriate rationale for 100% humidification of gases delivered to an artificial airway.
   7. Explain the procedure for tracheostomy wound care.
   8. Define “minimal occluding volume” and “minimal leak technique.”
   9. Explain the procedure to achieve a “minimal occluding volume” and “minimal leak”
   10. Explain disadvantages of periodic deflation of cuff vs the use of minimal occluding volume or minimal leak.
   11. Identify and explain methods to deal with artificial airway emergencies.
   12. Give an appropriate rationale for suggesting discontinuance of an artificial airway.
   13. Demonstrate the appropriate technique for endotracheal extubation.
   14. Identify clinical signs of laryngospasm and appropriate methods to deal with it.
   15. Identify and explain the function of:
       1. Fenestrated tubes
       2. Tracheal buttons
       3. Talking trach tubes
   16. Identify and explain the complications of artificial airways.
   17. Explain appropriate methods to deal with complications of artificial airways.
   18. Explain the causal factors of tracheal stenosis.
   19. Explain the pathophysiology of tracheal wall pressure.
   20. Explain the physics of tracheal cuffs.
   21. Identify and explain the function of the foam cuff trach tube.
4. Demonstrate an understanding of various suctioning techniques.
   1. Identify indications for airway suctioning
   2. Explain the complications of airway suctioning.
   3. Describe techniques to minimize these complications.
   4. Compare nasotracheal vs endotracheal suctioning.
   5. Describe the design and function of the “ideal” suction catheter.
   6. Explain the function of specialty suction catheters or systems.
   7. Assemble the appropriate equipment for airway suctioning.
   8. Demonstrate the appropriate technique for airway suctioning.