INSTRUCTIONS. The following questions are to be answered by writing the answer in the space provided or by matching terms as directed. After you have completed all the questions, scroll down to the answers at the end of the exercises and check your responses.
1. A venous cut-down procedure is being performed. The primary site for this procedure is _______________________________, which is located at the_____________________.
2. The secondary site for a venous cut-down procedure is the ________________, located close to the ___________________.
3. List three possible complications of a venous cut-down.
a. _______________________________________________.
b. _______________________________________________.
c. _______________________________________________.
4. Needle decompression is ___________________________________________
________________________________________________________________.
5. List three indications that needle decompression should be performed under controlled conditions.
a. _______________________________________________.
b. _______________________________________________.
c. _______________________________________________.
6. List three indications that the patient needs a chest tube insertion.
a. _______________________________________________.
b. _______________________________________________.
c. _______________________________________________
7. What is the primary indication for creating a surgical airway?
________________________________________________________________
________________________________________________________________
8. The two qualifications a 68W Medical NCO must have to perform a surgical cricothyrotomy are:
a. _______________________________________________.
b. _______________________________________________.
9. To insert the cannula properly when you are performing a surgical cricothyrotomy, you should:
a. Keep your left hand on the ___________________ to stabilize it.
b. Pick up the cannula in your __________________ hand.
c. Place the cannula through the puncture hole, with the cannula tip pointing toward the patient’s _________________________.
d. Using controlled force, advance the cannula until the _______________ is flush with the skin.
e. If you are using a cuffed tracheostomy tube, __________________ the cuff.
10. To check for correct placement of the cannula in a patient who has had a surgical cricothyrotomy, you should:
a. ________________________________________________.
b. _______________________________________________.
11. Listed below are the major steps in the procedure of inserting a chest tube. Place the steps in the order in which they would be performed.
| a. _____
b. _____ c. _____ d. _____ e. _____ f. _____ g. _____ h. _____ |
S. Apply a dressing.
T. Explore the pleural space. U. Suture the skin, securing the chest tube. V. Insert the chest tube. W. Locally, anesthetize the skin and periosteum if there is time. X. Prep and drape the patient. Y. Perforate into the pleural space. Z. Incise the skin and create a tunnel. |
Check Your Answers
1. The greater saphenous vein; ankle. (para 3-2a(1))
2. The antecubital median basilic vein; elbow. (para 3-2a(2))
3. You are correct if you listed any three of the following:
Cellulitis.
Hematoma.
Phlebitis.
Perforation of the posterior wall of the vein.
Venous thrombosis.
Nerve transection.
Arterial transection. (para 3-2c(1) through (7))
4. Needle decompression is the removal of air and fluid from the chest cavity by puncture. (para 3-3)
5. You are correct if you listed any three of the following:
Severe respiratory distress.
Jugular vein distention.
Hyper resonance on the affected side.
Absent or diminished breath sounds on the affected side.
Pulseless paradox (the radial pulse fades or disappears upon inspiration).
Tracheal deviation may be seen but is considered a very late and grave sign.
(para 3-3a(2)(a)-(f))
6. The patient has hemothorax.
The patient has pneumothorax.
The patient has tension pneumothorax. (para 3-4a)
7. The primary indication to create a surgical airway is the need for an airway for a patient who cannot be intubated. (para 3-6a)
8. Thoroughly trained in the procedure.
Approved by the physician directors to perform a cricothyrotomy. (para 3-5b, NOTE)
9. a. Larynx.
b. Dominant.
c. Feet.
d. Flange.
e. Inflate. (para 3-5(b)(4)(a)-(e))
10. a. Listen and feel for air flow through the cannula
b. His chest rises and falls with each ventilation. (para 3-5b(5)(a), (b)
11. a. X
b. W
c. Z
d. Y
e. T
f. V
g. U
h. S (para 3-4c(3)-(12))