Airway Management, Ventilation, And Oxygen Therapy

Front 1

What are three airway hazards rarely seen in the field?

Back 1

1. Oxygen intoxicty or air sac collapse
2. Infant eye damage
3. Respiratory depression or respiratory arrest.

Front 2

What is oxygen toxicity?

Back 2

Oxygen toxicity or air sac collapse occurs when the body reacts to a sensed “overload” of oxygen by reduced lung activity and air sac collapse. (COPD patient condition)

Front 3

What is infant eye damage?

Back 3

Infant eye damage may occur when premature infants are given too much oxygen. These infants may develop scar tissue on the retina of the eye.

Front 4

What is hypoxic drive?

Back 4

Respiratory depression or respiratory arrest occuring when the COPD patient’s body may use low blood oxygen as the factor that stimulates him to breathe, referred to as hypoxic drive.

Front 5

What are the hazards of oxygen therapy?

Back 5

1. Fire
2. Explosion (pressured oxygen mixed with ol)
3. Oxygen tank projectile if the tank is punctured or the valve is broken.

Front 6

Name the oxygen delivery devices, thier flow rate limits and oxygen concentration limits.

Back 6

1. Nonrebreather mask, 12-15 lpm, provides 80-90% O2 concentration
2. Nasal cannula, 1-6 lpm, provides 24-44% O2 concentration
3. Venturi mask, Up to 15 lpm, provides 24-60 lpm

Front 7

When should a nonrebreather mask be used?

Back 7

A NRB mask should be used:

1. For patients with signs of inadquate breathing
2. For patients showing signs of:
- cyanosis
- cool, clammy skin
- short of breath
- with angina pectoris (severe chest pain)
- severe injuries
- altered mental status

Front 8

What are the three major types of flowmeters?

Back 8

1. Pressure-Compensated Flowmeter
2. Bourdon Gauge Flowmeter
3. Constant Flow Selector Valve

Front 9

How much pressured oxygen can an oxygen cylinder contain?

Back 9

2,000 - 2,200 pounds per square inch (psi)

Front 10

What are the various sizes of oxygen cylinders?

Back 10

For emergencey care:
1. D cylinder (350 liters of oxygen)
2. E cylinder (625 liters of oxygen)
3. M cylinder (3,000 liters of oxygen)

For fixed ambulance systems:
4. G cylinder (5,300 liters of oxygen)
5. H cylinder (6,900 liters of oxygen)

Front 11

The reduction of breathing to the point where oxygen intake is not sufficient to support life

Back 11

respiratory failure

Front 12

When breathing stops completely, the patient is in:

Back 12

respiratory arrest

Front 13

Under what conditions will respiratory arrest occur?

Back 13

Respiratory arrest can develop during
1. heart attack,
2. stroke,
3. airway obstruction,
4. drowning,
5. electrocution,
6. drug overdose,
7. poisoning,
8. brain injury,
9.severe chest injury,
10. suffocation, or
11. prolonged respiratory failure.

Front 14

What are the three commonly used broncholdilaters?

Back 14

1. albuterol (Proventil, Ventolin)
2. metaproterenol (Metaprel, Alupent)
3. isoetharine (Bronchosol, Bronkometer)

Front 15

The passage by which air enters or leaves the body.

Back 15

airway

Front 16

What are the structures of the airway?

Back 16

The nose, mouth, pharynx, larynx, trachea, bronchi, and lungs.

Front 17

Forcing air or oxygen into the lungs when a patient has stopped breathing or has inadequate breathing, Also called positive pressure ventilation

Back 17

artificial ventilation

Front 18

A device that provides positive pressure ventilations. It includes settings designed to adjust ventilation rate and volume, is portable, and is easily carried on an ambulance

Back 18

automatic transport ventilator (ATV)

Front 19

a handheld device with a face mask and self-refilling bag that can be squeezed to provide artificial ventilations to a patient. It can deliver air from the atmosphere or oxygen from a supplemental supply system

Back 19

bag-valve mask (BVM)

Front 20

a blue or gray color resulting from lack of oxygen in the body

Back 20

cyanosis
(SIGH-uh-NO-sis)

Front 21

areas of the lungs outside the alveoli where gas exchange with the blood does NOT take place

Back 21

dead space

Front 22

A valve that indicates the flow of oxygen in liters per minute

Back 22

flowmeter

Front 23

A device that uses oxygen under pressure to deliver artificial ventilations. Its trigger is placed so that the rescuer can operate it while still using both hands to maintain a seal on the face mask. It has automatic flow restriction to prevent overdelivery of oxygen to the patient

Back 23

flow-restricted, oxygen-powered ventilation device

Front 24

vomitting or retching that results when something is place in the back of the pharynx.

Back 24

gag reflex

Front 25

A means of correcting blockage of the airway by te tongue by tilting the head back and lifting the chin. Used when NO trauma, or inury is suspected

Back 25

head-tilt, chin-lift maneuver

Front 26

A device connected to the flowmeter to add moisture to the dry oxygen coming from an oxygen cylinder

Back 26

humidifier

Front 27

To provide ventilations at a higher rate than normal

Back 27

hyperventilate

Front 28

An insufficiency of oxygen in the body's tissues

Back 28

hypoxia
(hi-POK-se-uh)

Front 29

A means of correcting blockage of the airway by moving the jaw forward without tilting the head or neck. Used when trauma, or injur IS suspected to open the airway without causing furtherinjury to the spinal cord in the neck

Back 29

jaw-thrust maneuver

Front 30

= (amount of air breated in) X (# of breaths per minute)

Back 30

minute volume (inhaled air)

Front 31

A device that delivers low concentrations of oxygen through two prongs that rest in the patient's nostrils

Back 31

nasal cannula

Front 32

A flexible breathing tube inserted through the patient's nose into the pharynx to help maintain an open airway

Back 32

nasopharyngeal
(NAY-zo-fah-RIN-jul)

Front 33

A face mask and reservoir bag device that delivers high concentrations of oxygen.

Back 33

nonrebreather mask

Front 34

A curved device inserted through the patient's mouth into the pharynx to help maintain an open airway

Back 34

oropharyngeal
(OR-o-fah-RIN-jul)

Front 35

A cylinder filled with oxygen under ressure

Back 35

oxygen cylinder

Front 36

An airway that is open and clear and will remain open and clear, without interference to the passage of air into and out of the body

Back 36

patent airway

Front 37

A device, usually with a one-way valve, to aid in artificial ventilation. A rescuer breathes through the valve when the mask is placed over the patient's face. It also acts as a barrier to prevent contact with a patient's breath or body fluids. It can be used with supplemental oxygen when fitting with an oxygen inlet.

Back 37

pocket face mask

Front 38

positive pressure ventilation

Back 38

artificial ventilation

Front 39

A device connected to an oxygen cylinder to reduce cylinder pressure so it is safe for delivery of oxygen to a patient

Back 39

pressure regulator

Front 40

Respiration

Back 40

breathing

Front 41

When breathing completely stops

Back 41

respiratory arrest

Front 42

Increased work of breathing; a sensation of shortness of breath

Back 42

respiratory distress

Front 43

The reduction of breathing to the point where oxygen intake is not sufficient to support life

Back 43

respiratory failure

Front 44

A permanent surgical opening in the neck through which the patient breathes

Back 44

stoma

Front 45

Use of a vacuum device to remove blood, vomitus, and other secretions or foreign materials from the airway

Back 45

suctioning

Front 46

The breathing in of air or oxygen or providing breaths artificially

Back 46

ventilation

Front 47

A face mask and reservoir bag device that delivers specific concentrations of oxygen by mixin oxygen with inhaled air

Back 47

Venturi mask

Front 48

What are the signs and symptoms of inadequate breathing?

Back 48

Signs/Symptoms of Inadequate Breathing

1. Patient has some breathing but not enough to live
2. Respiration rate outside of normal limits (very slow or very rapid)
3. Respiration rhythm is irregular
4. Depth of breaths (tidal volume) are shallow
5. Diminshed or absent breath sounds
6. Chest expansion inadequate or unequal, increased effort
7. Use of accesory muscles in breathing
8. Skin: pale or blue (cyanotic), cool and clammy
9. Noises such as crowing, stridor, snoring, gurgling, or gasping (agonal respirations)

Front 49

In order of preference, what are the patient care methods for inadequate breathing?

Back 49

Patient Care for Inadequate Breathing

Provide assisted ventilation with supplemental oxygen. In order of preference:

1. Pocket face mask with supplemental oxygen
2. Two-rescuer bag-valve mask with supplemental oxygen
3. Flow-restricted, oxygen-powered ventilation device
4. One rescuer bag-value mask with supplemental oxygen

Front 50

What are the signs and symptoms of adequate breathing?

Back 50

Signs/Symptoms of Adequate Breathing

1. Patient is breathing adequately but needs supplemental oxygen for medical or trauma conditions
2. Rate and depth are adequate
3. No abnormal breaths
4. Air moves freely in and out of chest
5. Skin color normal

Front 51

What is the patient care for adequate breathing?

Back 51

Patient Care for Adequate Breathing

1. Provide oxygen by non-rebreather mask or nasal cannula

Front 52

What are the signs and symptoms of apnea (no breathing)?

Back 52

Signs/Symptoms of Apnea (no breathing)

1. No chest rise
2. No evidence of air being moved from the mouth or nose
3. No breath sounds

Front 53

What is the patient care for apnea (no breathing)?

Back 53

Patient care for apnea (no breathing)

1. Assist ventilations with a pocket face mask, bag-valve mask, or FROPVD
2. Provide high-concentrated oxygen at a rate of 12/minute for an adult and 20/minute for an infant or child

Front 54

What are the symptoms of breathing difficulty?

Back 54

Symptoms of breathing difficulty:

1. Shortness of breath
2. Tightness in chest
3. Restlessness or anxiety

Front 55

What are the signs of breathing difficulty?

Back 55

1.Decreased pulse rate (esp. in infants and children)
2. Retractions (esp. in infants and children)
3. Flared nostrils (esp. in infants and children),
4. Increased pulse rate
5. Changes in breathing rate
6. Changes in breathing rhythm
7. Pale, cyanotic, or flushed skin
8. Noisy breathing: audible wheezing, gurgling, snoring, crowing, stridor
9. Inability to speak in full sentences
10. Use of accessory muscles
11. Altered mental status
12. Coughing
13. Pursed lips
14. Patient positioning: tripod position, sitting with feet dangling, leaning forward
15. Unusual anatomy (barrel chest)
16. Oxygen saturation, or SpO2, reading < 95% on the pulse oximeter
17. Grunting and seesaw breathing (esp. in infants and children)

Front 56

What is the patient care for breathing diffculty?

Back 56

Patient care for breathing diffculty

1. Assessment: Assess the airway throughout the cal
2. Oxygen: Provide appropriate oxygen therapy and assisted ventilation
3. Positioning: Place the patient in a position of comfort (Fowler's position or supine)
4. Prescribed inhaler: With medical direction approval assist patient with taking medication

Front 57

AVPU is a mnemonics use to establish levels of consciousness

Back 57

A - Alert
V - Verbal
P - Pain
U - Unresponsive

Front 58

blocked

Back 58

occluded

Front 59

What are the structures of the respiratory system?

Back 59

Nose, mouth, pharynx (oropharynx, nasopharynx), Uvula, epiglottis, larynx(voice box includes: Thyroid cartilage, cricoid cartlage), trachea,carina, bronchi, bronchioles, lungs, alveoli, diaphragm

Front 60

What are the normal breathing parameters?

Back 60

Normal rates
Adult - 12-20 breaths per minute
Child - 15-30 breaths per minute
Infant - 25-50 breaths per minute
Rhythm - regular
Depth - Adequate
Quality - Breath sounds: present and equal; Chest expansiion: adequate and equal; Minimum effort

Front 61

What are the rules for suctioning?

Back 61

1. Use appropriate BSI - eyewear, mask, disposable gloves
2. Limit suctioning to less than 15 seconds at a time
3. Place the tip where you want to begin the suctioning and suction on the way out
4. Suctio nwith the patient turned on his side
5. Stop suctioning if the patient gags or becomes conscious