Airway and pulmonary optimization in the early postoperative period
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Author Information
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- Details
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Jared Hargett, DNP(c), BSN, RN; David Fort, DNP, CRNA
- Sigma Affiliation
- Non-member
- Contributor Affiliation(s)
- Samford University, Birmingham, Alabama, USA
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Abstract
Hypoxia in the early postoperative period can be the result of a various number of causes. Anesthesia providers must be able to quickly identify possible causes of hypoxia and apply appropriate pulmonary interventions. Potential causes of hypoxia can result from residual neuromuscular blockade from paralytic agents, respiratory depression from narcotic administration, laryngospasm, or an airway obstruction. Upper airway anatomy consists of cartilage and bone structures of the nose and mouth, followed by the soft tissue of the oropharynx and hypopharynx, and ending at the glottic opening of the vocal cords. The soft tissue of the oropharynx is prone to collapse in the anesthetized patient and may be further compromised by obesity, airway edema, obstructive sleep apnea, and external compression. In response to this risk of airway collapse, anesthesia providers must quickly be able to recognize an airway obstruction and employ airway and pulmonary interventions. Each potential cause of hypoxia necessitates a different intervention in order to optimize gas exchange. Inability to adequately recognize the source of hypoxia can result in devastating consequences leading to cyanosis and anoxic brain injury. A patient that experienced an airway obstruction in the postoperative period required an oral airway device and a two handed jaw thrust maneuver in order to improve gas exchange and ultimately reverse the hypoxia. Key indicators leading the anesthetist in identifying the airway obstruction consisted of difficult bag mask ventilation, snoring, decreasing Sp02, and cyanotic lips. Additional interventions to improve gas exchange included applying continuous positive pressure ventilation in the recovery room with a CPAP machine and raising the head of the bed. Understanding the continuation of airway management in the early postoperative period is key in preventing adverse pulmonary complications.
Repository Posting Date
2021-03-24T17:09:53Z
Type Information
Type | Poster |
Acquisition | Proxy-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Category Information
Evidence Level | Case Study/Series |
Research Approach | Translational Research/Evidence-based Practice |
Keywords | Hypoxia; Airway Obstruction; Sleep Apnea; Postoperative |
Degree Information
Grantor | Samford University |
Advisor | Fort, David; Rankin, Heather |
Level | DNP |
Year | 2021 |
Conference Information
Name | Ida Moffett School of Nursing DNP Poster Presentation |
Host | Samford University |
Location | Birmingham, Alabama, USA |
Date | 2021 |
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