What type of lubrication is used for fiberoptic bronchoscopy?
Dimethylpolysiloxane- only on tip of scope.
What 3 movements are possible with FFOB?
- Longitudinal- enter and leave airway
- Rotational- 180 degrees around long axis
- Angulation- flexion and extension of tip from 90 to 180 degrees
When using FFOB what is important with positioning?
- max distance btw operator and pt
- orient scope so greater flexion in ventral direction
What techniques can be used to create air space when using FFOB?
- Displace tongue: 4x4. jaw thrust, suction
What catheter is used with FFOB?
- ID- 4.7 mm
- OD- 6.5 mm
- L- 56 cm
- Greater than 7.0 tube needed
ETT introducer has a ______, and ________. You will get _______ _______ when you enter the trachea, comfirming correct position.
- lumen (HPOV)
- memory (at tip)
- tactile feeback
What must be seen if using ETT introducer?
tip of epiglottis
What are possible complications of ETT introducer?
- Tracheal abrasion
- tracheal, laryngeal, pharyngeal puncture (leading to infection or bleeding)
- failure to obtain glottic entry
- failure to pass ETT
What is the length of a 6.0 mm ETT introducer?
What is the purpose of HPOV?
When should HPOV not be used?
in presence of COMPLETE airway obstruction.
When assembling HPOV equipment, the stopcock should be turned so that......?
all ports are open.
What is the prevalence of obesity in the us?
- costs 150 billion annually
What should be goal A for intubating an obese patient? What about plan B?
- Safe first attempt:
- Optimize position
- B: have a predetermined endpoint of when to start B, don't forget about ETT introdcuer
When positioning obese pt's, try to optimize room for mandibular and soft tissue movement bc? How is this done?
- space is limited
- elevating trunk before putting in sniff position
What is the ultimate goal with intubating obese pt's?
- keep oxygenated
- *they desat quickly*
_____ decreases as BMI increases.