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75 Cards in this Set
- Front
- Back
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What are the difference between a child and adult airway
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Child has a smaller nose and mouth
A child's tongue takes up more space Child's trachea is narrower Child's cricord cartilage is less rigid and less developed Child Airway is more easily obstructed |
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Describe the Inhalation Process
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The active part of breathing
Diaphragm and intercostal muscles contract Air travels into lungs to alveoil |
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Describe the Exhalation Process
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Does not normally require muscular effort
Diaphragm and intercostal musles relax Thorax decreases in size |
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Define Tidal Volume
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The amount of air you move during the process of breathing
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What does it mean to "Clear the Airway"
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Removing an object or blockage
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What does "Maintaining the Airway" mean
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The processes or techniques used to keep the airway open
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How is time critical in the body's need for oxygen?
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0 to 1 Minute Cardiac irritability
0 to 4 minutes Brain damage NOT likely 4 to 6 minutes Brain damage possible 6 to 10 minutes Brain damage LIKELY More than 10 Minutes Irreversible brain damage |
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What is Hypoxia
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Lack of oxygen to the body
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What are the signs and symptoms of Hypoxia
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Nervousness, irritability and fear
Rapid Heart rate Mental status changes Excessive use of accessory muscles for breathing Difficulty breathing (Dyspnea) and possible chest pain |
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What conditions can cause Hypoxia
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Myocardial Infarction
Pulmonary Edema Acute Narcotic Overdose Smoke Inhalation Stroke Chest Injury Shock Lung Disease |
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What is Hypoxic Drive
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"The need to breath"
Hypoxic drive causes us to breath when the oxygen level in our bodies get to low. |
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A respiratory Assessment is accomplished by-
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Looking
Listening Feeling |
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What are the normal respiration rates for Adults children and infants
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Adult 8 - 24
Child 15 - 30 Infant 25 - 50 |
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What are the signs of adequate breathing
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Normal rate and depth
Regular pattern Clear and equal lung sounds Adequate depth |
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What are the signs of inadequate breathing
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Labored breathing
Use of accessory muscles in breath Pale or blue skin (Cyanosis) Cool, clammy skin Irregular pattern Snoring respiration 2-3 word sentences Cheyene Stokes respiration |
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What are Cheyne Stokes Respiration
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Irregular respiratory pattern
Increasing rate and depth followed by period of apnea |
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Where do you often see Cheyne Stokes Respiration
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In patients presenting with stroke and head injuries
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What are signs of inadequate breathing in infants and children
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Nasal flaring
See-saw breathing Retractions |
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How do you open the airway in medical patients
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Head tilt / chin lift
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How do you open the airway in patients suspected of trauma or spinal injury
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Jaw thrust
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What is the ABC of patient assessment
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Airway
Breathing Circulation |
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Name two basic airway adjuncts used by EMT-B
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Oropharyngeal Airway or OPA
Nasopharyngeal Airway or NPA |
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What are the uses of the oropharyngeal airway
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Keeps the tongue from blocking the upper airway
Allows for easier suctioning of the airway Used in conjunction with BVM Used on unconscious patients with no gag reflex |
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How do you size an OPA
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Tip of the ear to the corner of the mouth
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How do you insert an OPA
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Open patients mouth
Hold the OPA upside down and insert it in the patients mouth Rotate the airway device 180 degrees until the flange rest on the patients lips |
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What are the uses of the Nasopharyngeal Airway
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Used on conscious patients who can't maintain an airway
On unconscious patients with a gag reflex Should not be used on patients with possible skull fractures |
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How do you determine the proper size NPA to use
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Corner of nose to ear lobe
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What should be done to the NPA for easier insertion
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Lubricate with water based lubricant
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How to you insert the NPA
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Open the patients nostril
Turn the NPA so beveled end is towards the septum Gently push it in |
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What is suctioning used for
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To remove blood and other liquids, food and other particles from the airway
When you hear gurgling - SUCTION! |
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Name 5 types of suctioning equipment that may be used or carried by EMT's
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Mounted (hospital or ambulance)
Battery powered portable Oxygen Powered Manual Bulb syringe |
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Name the two types of suctioning catheters
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Hard
Soft |
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What are the characteristic of the Hard suction catheter
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AKA Yankaur or rigid tip
Used on most patients |
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What are the characters of the soft suction catheter
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AKA French tip or whistle tip
May be used for stoma, nasopharynx or infants |
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What are some suctioning techniques
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Preoxygenate the patient if possible
Be careful not o force objects into the airway when ventilating patients if suctioning may be required Check the nit and turn it on Select and measure the proper catheter Suction on the way out not on the way in |
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What are the standard suctioning times for adults and children
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No more than 10 seconds for children
No more than 15 seconds for adults |
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How do you measure for proper suctioning depth
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Corner of the mouth to the tip of the ear.
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Who gets Oxygen?
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All patients
Especially cardiac or respiratory patients Never withhold oxygen from anybody that may benefit from it |
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What are some conditions that should receive oxygen?
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Cardiac and respiratory troubles
Stroke shock Blood loss or fractures |
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What is the pin-indexing safety system
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On oxygen cylinders when the flow meters connect there are two pin holes for the two pins on the flow meter
They are for ease of positioning the flow meter in the correct location for tightening and if the two pin holes don ot exist its probably not oxygen |
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Name Two types of flow meters
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Pressure Compensated Flow Meter
Bourdon - Gauge Flow meter |
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Which type of Flow Meter is effected by gravity
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Pressure Compensated
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Which Flow Meter can be used in any position
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Bourdon-gauge
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List the proper steps to setup and use the Supplemental oxygen
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Inspect cylinder and markings
Crack the cylinder to get rid of dust or debris Attach regulator flow meter Open the cylinder Attach the proper delivery device to flow meter Adjust the flow meter to desired liter flow apply the oxygen device to the patient when done discard the delivery system Turn off the flow meter |
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What are the hazards in oxygen
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It support combustion
Keep possible ignition sources away from the area Oxygen tanks are under high pressure |
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What is oxygen measured in
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Liters
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Name the two types of delivery systems
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Non-Re-breather
Nasal Cannula |
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What are the characteristics of the non-re-breather
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Provides up to 90% Oxygen
Used at 10/15 liters/min |
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What are the characteristics of the nasal cannula
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Provides 24 to 44 % oxygen
used at 1 to 6 Liters/min |
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Name 4 types of artificial respiration
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Mouth to mouth
mouth to mask BVM Flow restricted oxygen powered ventilation system |
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What is a FROPD (pronounced Frop-Dee)
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a Flow Restricted Oxygen Powered Ventilation device
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In order what are te preferred methods of ventilation
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Mouth to mask
2 person BVM with supplemental Oxygen 1 Person BVM with supplemental oxygen |
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What is the minimum level of Oxygen delivered to the patient when using mouth to mask
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16%
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How many sizes of BVM are there
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3
Adult Child Infant |
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What is cricord pressure
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Used on unconscious patients to prevent gastric distention (air in the stomach)
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How do you apply cricord pressure
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Place pressure on the cricord cartilage with thumb and index finger
This pushes the trachea down to occlude the esophagus |
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What is the cause of gastric extension
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Occurs when the ventilation is to forceful or frequent or when the airway is blocked
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Why do we want to prevent gastric distention?
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It causes the patient to vomit and may block the airway
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What causes Foreign body obstructions
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Relaxation of the tongue
Vomited stomach contents Blood clots, bone fragments and damaged tissue Foreign objects |
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How can you recognize an obstruction
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Is the patient able to speak or cough?
If patient is unconscious attempt to deliver artificial ventilation |
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When do foreign body obstructions usually happen?
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In adults when they are eating
In children when they are eating or playing with small toys or crawling about the house |
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What are the special concerns with facial injuries
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There are many blood vessels in the face
When damaged it can lead to severe swelling and bleeding into the airway |
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How do you ventilate a patient with a Stoma or tracheotomy
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Deliver the ventilation through the stoma
The stoma can be suctioned When using the BVM use the infant mask attach the oxygen tube |
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How do you handle a patients Dentures when dealing with the airway
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Leave them in place unless they are blocking the airway
If partial plate becomes loose leave it in place unless it causes a problem Be sure to maintain control of the patients dentures as they are expensive |
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What are the special considerations that need to be taken into account when the patients are children
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Avoid hyper extension when opening the airway
Avoid excessive pressure when ventilating Gastric distension is common Use the proper size BVM, non re-breather and suctioning catheter |
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What are the considerations when using Pulse Oximetry
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Does not necessarily evaluate the effectiveness of oxygenation (CO vs O2)
Place the probe on finger, toe, earlobe Its only a tool! Does not replace good patient assessment! Treat the Patient not the tools! |
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List the parts of the upper airway
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Nose
Nasopharynx Mouth Oropharynx Pharynx Larynx Epiglottis Vocal cords Esophagus |
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What organs are located in the mediastinum
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The middle of the thoracic cavity behind the lungs
Contains the Trachea Heart Vena cava Aorta Esophagus |
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What is Apnea
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Absence of breathing or respiratory arrest
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What is Dyspnea
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Shortness of breath or perceived difficulty in breathing
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What is tachypnea
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A breathing rate that is faster than the normal rate
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How can you assess LOC
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AVPU
GCS Ask questions as to who, where, what |
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What do you need to determine in you general impression
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Age, Sex, Race, MOI or NOI, Life threatening injuries
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What needs to be determined in a Scene Sizeup
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BSI
Scene Safe? MOI or NOI # of Patients Need for more resources |
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What are the steps in a patient assessment
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Scene size up
Initial Assessment Focused History and Physical Exam Detailed physical exam Ongoing assessment |
