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155 Cards in this Set

  • Front
  • Back
What does "ABC" stand for when you're doing the patient assessment?
Airway, Breathing, and Circulation
What do you call the area directly posterior to the nasal cavity?
The nasopharynx
What do you call the area directly posterior to the oral cavity?
The oropharynx
What do you call the area that is composed of the nasopharynx and oropharynx?
The pharynx
What is the u-shaped bone on the anterior aspect of the cervical region situated directly superior to the larynx?
The hyoid bone
What important organ protects the trachea and has many components, including the thyroid cartilage and cricoid cartilage?
The larynx
What ring of cartilage is found just inferior to the thryoid cartilage?
The cricoid cartilage
What ring of cartilage is found just superior to the cricoid cartilage?
The thyroid cartilage
What are the organelles found in cells in the trachea and lungs that help propel mucus and dirt out of the body?
Cilia
What are the two large branches that originate at the trachea and bring air into the right and left lungs?
Bronchi
What are the smaller branches that originate at the bronchi and bring air to alveoli in the lungs?
Bronchioles
What do you call the sacs at the end of the bronchioles that are encircled by capillaries and are integral in oxygen/carbon dioxide exchange?
Alveoli
Which lung is larger?
The right lung -- it has three lobes instead of two
What do you call the cavity between the lungs?
The mediastinum.
What is the muscle inferior to the lungs that's the major muscle responsible for inspiration?
The diaphragm
What do you call the site at which the trachea branches into the bronchi?
The carina
Which one of these processes is active: inhalation, or exhalation?
Inhalation -- it requires energy in the form of muscle contractions.
Define "respiratory distress."
Respiratory distress is characterized by a sensation of shortness of breath, and physically presents as labored breathing. It's basically having to put forth effort to keep breathing adequate.
Define "respiratory failure."
The reduction of breathing to the point where oxygen intake is not sufficient to support life.
Define "respiratory arrest."
When breathing completely stops.
What should one be looking for when judging whether a patient's breathing is adequate or inadequate?
Adequate expansion on both sides of the chest
What should one be listening for when judging whether a patient's breathing is adequate or inadequate?
For air leaving the chest (bad sign!) or leaving the mouth and nose (good sign!)
What should one be feeling for when judging whether a patient's breathing is adequate or inadequate?
For air leaving the chest (bad sign!) or leaving the mouth and nose (good sign!)
What are adequate breathing rates for children, adults, and infants?
Adults: 12-20 breaths/minute
Children: 15-30 breaths/minute
Infants: 25-50 breaths/minute
Define "hypoxia."
Inadequate oxygen being delivered to cells
What are 8 symptoms of mild to moderate hypoxia?
1) Tachypnea (fast breathing)
2) Dyspnea (poor breathing)
3) Tachycardia (fast heart rate)
4) Pale, cool skin
5) Restlessness
6) Disorientation
7) Headache
8) Hypertension
What are some symptoms of severe hypoxia?
1) Tachycardia progressing to bradycardia (heart rate drops = trouble!)
2) Dyspnea (poor breathing)
3) Pale, cool skin
4) Drowsiness
5) Altered mental status
6) Accessory muscle use
Define the EMT's primary goal in one sentence.
To immediately find and correct life-threatening problems pertaining to airway, breathing, and circulation (ABC).
Name some events that might trigger respiratory arrest.
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
11) Prolonged respiratory failure
Define "minute volume."
The amount of air breathed in during each respiration multiplied by the number of breaths per minute.
How would you intervene if you found a patient that was breathing adequately but required supplemental oxygen due to a medical or traumatic condition?
Give supplemental oxygen via nonrebreather mask or nasal cannula
How would you intervene if you found a patient that was breathing inadequately?
Give assisted ventilations with a pocket face mask, bag-valve mask, or FROPVD. Do NOT use FROPVD on children or infants.
How would you intervene if you found a patient that was in respiratory arrest?
Give artificual ventilations with a pocket face mask, a bag-valve mask, FROPVD, or ATV at 10-12/minute for adults, 20/minute for a child.
When giving artificial ventilations to an adult, how many ventilations should you give per minute?
10-12 ventilations per minute
When giving artificial ventilations to a child, how many ventilations should you give per minute?
20 ventilations per minute
If a patient is speaking in full sentences and is alert and calm, is that patient breathing adequately or inadequately?
Adequately. If they are complaining of shortness of breath, though, provide them with a nonrebreather mask or a nasal cannula.
If a patient is visibly short of breath and is speaking in 3-4 word sentences with anxiety increasing, is that patient breathing adequately or inadequately?
That patient is on the cusp. A nonrebreather mask might be a good idea.
If patient is speaking only 1-2 word sentences, is very sweaty, and is exhibiting severe anxiety, is that patient breathing adequately or inadequately?
Patient is breathing inadequately and needs assisted ventilations. Provide them with a pocket face mask (PFM), bag-valve mask (BVM), or flow-restricted oxygen-powered ventilation device (FROPVD). Assist ventilations before they stop altogether!
Define the anatomic "dead space" of the respiratory system.
Areas of the lungs outside the alveoli where gas exchange with the blood does not take place.
Why is it important to keep in mind the anatomic "dead space?"
Because even when the depth and rate of breathing changes, the amount of dead space does not. So when breaths become more shallow, a greater proportion of each breath is wasted in the dead space.
During a normal breath, what percentage of each inhalation rests in the anatomic dead space of the respiratory system?
About 30%.
What are the four principal procedures to treat life-threatening respiratory problems?
1) Opening and maintaining the airway

2) Providing artificial ventilation to the nonbreathing patient and the patient with inadequate breathing

3) Providing supplemental oxygen to the breathing patient

4) Suctioning as needed
Define "airway."
The passageway by which air enters or leaves the body. The structures of the airway are the nose, mouth, pharynx, larynx, trachea, bronchi, and lungs.
What takes precedence: the spine, or airway and breathing?
Airway and breathing. If you find a non-breathing patient and suspect injury, you will probably have to provide manual stabilization and treat the breathing problem before you have time to put on a cervical collar.
What three indications do you have of a spinal injury, even with an unconscious patient?
1) Mechanism of injury - falls, car crashes, etc.

2) Location of injury - above the shoulders

3) Family or bystanders
Define "patent airway."
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.
What are four steps of positioning a prone patient for basic life support when you are the only rescuer present?
1) Straighten patient's legs, position the closest arm above the patient's head.

2) Grasp under the distant armpit

3) Cradling head and neck, move patient as a unit onto his side

4) Move patient onto back and reposition the extended arm
Most airway problems are caused by the ______.
Tongue
The risk of airway obstruction by the tongue is even greater when the patient is __________.
Unconscious
What two methods are used to clear the tongue out of the airway and open the airway wide?
1) Head-tilt/Chin-lift maneuver

2) Jaw-thrust maneuver (preferable when spine injury is suspected)
What are the four steps of performing the head-tilt/chin-lift maneuver?
1) Place one hand on the forehead and the fingertips of the other hand under the bony area at the center of the patient's lower jaw.

2) Tilt the head by applying gentle pressure to the patient's forehead

3) Use your fingertips to lift the chin and to support the lower jaw. Move the jaw forward to a point where the lower teeth are almost touching the upper teeth.

4) Do not allow patient's mouth to be closed.
What maneuver would you use to open the airway of an unconscious patient with suspected spine injuries?
The jaw-thrust maneuver
How do you perform the jaw-thrust maneuver?
1) Keep head, neck, and spine aligned, moving patient as a unit until he is supine.

2) Kneel at top of head.

3) Reach forward and place one hand on each side of the patient's lower jaw, at the angles of the jaw below the ears.

4) Stabilize head with forearms

5) Using index fingers, push jaw forward (patient's forward, not your forward :)

6) Retract lower lip with thumb if necessary

7) Do not tilt or rotate head
Define "ventilation."
The breathing in of air or oxygen or providing breaths artificially
Define "artificial ventilation."
Forcing air or oxygen into the lungs when a patient has stopped breathing or has inadequate breathing. Also called positive pressure ventilation.
What are the four major techniques available to an EMT for providing artificial ventilation, in order of preference?
1) Mouth to mask (preferably with oxygen at 15 liters/minute)

2) Two-rescuer bag-valve mask (BVM)(preferably with oxygen at 15 liters/minute)

3) Flow-restricted oxygen-powered ventilation device

4) One-rescuer bag-valve mask (preferably with oxygen at 15 liters/minute)
What are the signs of adequate artificial ventilation?
1) Chest rise

2) Heart rate returning to normal

3) Rate of ventilations is sufficient and not excessive
What are signs of inadequate artificial ventilation?
1) Chest doesn't rise and fall

2) Patient's heart rate does not return to normal

3) Rate of ventilation is inadequate or excessive.
What guidelines must you follow when preparing to attempt ventilation on a conscious patient with rapid ventilations?
1) Assess adequacy of respirations

2) Explain procedure to the patient

3) Place mask over mouth and nose

4) After sealing the mask, squeeze the bag with the patient's inhalation. Watch as the patient's chest begins to rise and deliver the ventilation with the start of patient's own inhalation. Over the next several breaths, adjust the rate so you are ventilating fewer times, but deeper.
What guidelines must you follow when preparing to attempt ventilation on a conscious patient with slow ventilations?
1) Carefully assess adequacy of respirations

2) Explain procedure to the patient

3) Place mask on face

4) After sealing mask, squeeze the bag with every inhalation. If the rate is very slow, add ventilations in between the patient's own to obtain a rate of approx. 12/minute.
Define "pocket face mask."
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 can be used with supplemental oxygen when fitted with an oxygen inlet.
Why is it important to use a clear face mask?
So you can observe the patient's mouth and nose for vomiting or secretions that need to be suctioned.
What steps must you follow in order to provide mouth-to-mask ventilation?
1) Position yourself at the patient's head and open the airway. It may be necessary to clear the airway of obstructions. If necessary, insert oropharyngeal airway to help keep airway open.

2) Connect oxygen to the inlet on the mask and run at 15 liters/minute. If oxygen isn't available, go ahead without it.

3) Position mask on the patient's face so that the apex is over the bridge of the nose and the base is between the lower lip and the chin. Center port over mouth.

4) Hold mask in place

5) Exhale into mask -- deliver breath over one second and watch for chest rise.

6) Remove mouth from port and wait for passive exhalation.
What important things must you remember when using a face mask on a patient with a spinal injury?
Do NOT tilt the head backward!
Define "bag-valve mask."
A handheld device with a face mask and a 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 oxygen supply system.
What steps must you follow in order to use a bag-valve mask on a patient without suspected spine injury?
1) Kneeling above patient's head, open airway and insert properly sized oral or nasal airway if no gag reflex is present.

2) Position thumbs over top of mask, index fingers at the bottom.

3) Place mask over patient's face. Position mask over nose and lower to the chin.

4) Use your middle, ring, and little fingers to bring jaw up to mask

5) Connect bag to mask and have assistant squeeze bag until chest rises.

6) If no rise, reevaluate head position and mask seal.

7) If unable to ventilate, use another method.
What additional step must one take when applying a bag-valve mask with two rescuers?
Make sure an assistant stabilizes and immobilizes the head and neck.
The use of a BVM is often reffered to as ______ the patient.
Bagging
Do bag-valve-mask units come in multiple sizes?
Yes, sizes for adults, children, and infants.
A BVM bag will hold between _____ and _____ mL of air.
1000 and 1600
What is the most difficult part of using a BVM?
Obtaining an adequate seal around the edges of the mask.
The AHA recommends that BVM artificial ventilation is performed by ___ rescuers.
Two
Define "stoma."
A permanent surgical opening in the neck through which the patient breathes.
What steps would you follow to provide artificial ventilations to a patient with a stoma?
1) Clear any mucus plugs or secretions from the stoma

2) Leave the head and neck in a neutral position, as it is unnecessary to position the airway prior to ventilations in a stoma breather.

3) Use a pediatric-sized mask to establish a seal around the stoma

4) Ventilate at the appropriate rate for the patient's age.

5) If unable to artificially ventilate through the stoma, consider sealing the stoma and attempting to ventilate through the mouth and nose. This will not work if the trachea has been disconnected from the mouth and nose.
What can you do to avoid gastric distension?
Make sure that the chest is rising when ventilating artificially. This shows that air is entering the lungs, not the stomach. Be especially careful when using a FROPVD.
What is the peak flow rate of most FROPVDs?
100 percent oxygen at up to 40 liters/minute
At what pressure level will the inspiratory pressure release valve on a FROPVD open?
60 cm of water pressure
When using a FROPVD and the chest doesn't rise, what should you do?
1) Reposition head

2) Check seal

3) Check for obstructions

4) Consider alternative methods of ventilation
Define "automatic transport ventilator."
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.
Define "oropharyngeal airway."
A curved device inserted through the patient's mouth into the pharynx to help maintain an oral airway.
Define "nasopharyngeal airway."
A flexible breathing tube inserted through the patient's nose into the pharynx to help maintain an open airway.
Define "airway adjunct."
A device that helps maintain an open airway.
What are the two most common airway adjuncts?
Oropharyngeal and nasopharyngeal airways.
What 9 general rules apply to the use of airway adjuncts?
1) Use an airway on all unconscious patients that don't exhibit a gag reflex.

2) Some patients that can't tolerate an oropharyngeal airway can tolerate a nasopharyngeal airway.

3) Open the airway manually before using an adjunct device.

4) When inserting the airway, take care not to push tongue into pharynx.

5) Do not continue inserting airway if patient begins to gag.

6) When an airway adjunct is in place, you MUST MAINTAIN the head-tilt/chin-lift, or jaw-thrust maneuver and monitor the airway.

7) When an airway adjunct is in place, you must remain ready to suction.

8) If the patient regains consciousness or develops a gag reflex, remove airway and prepare to suction immediately.

9) Use infection control practices!
How do you determine the best size of oropharyngeal airway for a patient?
Choose an airway that extends from the corner of the patient's mouth to the tip of the earlobe.
What steps do you follow to insert an oropharyngeal airway?
1) Place patient on his back. Keep spinal injuries in mind.

2) Perform a crossed-finger technique -- cross thumb and forefinger and push jaws open at teeth at corner of mouth.

3) Position airway so tip is pointing toward roof of mouth.

4) Insert airway and slide it along roof of mouth past the uvula or until you meet resistance at soft palate. Don't push tongue into pharynx. Use tongue depressor if necessary. (carefully insert the airway pointing DOWN and using a tongue depressor for children/infants)

5) Gently rotate airway 180 degrees. (unless already pointing down)

6) Position patient -- use maximum head tilt if no spinal injury, otherwise maintain straight and immobilized spine.

7) Check to see that flange of airway is against patient's lips.

8) Place mask over adjunct.

9) Provide ventilations and monitor patient closely. When removing device, there is no need to rotate it.
Which nasopharyngeal airway do you use in the field?
The soft flexible one, not the rigid clear plastic one.
What advantage does a nasopharyngeal airway have over an oropharyngeal airway?
It's less likely to initiate the gag reflex.
How does one determine the correct sizing for a nasopharyngeal airway?
Measure the nasopharyngeal airway from the nostril to the earlobe.
What steps must you follow when inserting a nasopharyngeal airway?
1) Measure airway from patient's nostril to earlobe.

2) Lubricate the tube with water-based lubricant.

3) Gently push tip of nose upward. Keep patient's head in neutral position. Try right nostril first, and make sure that the bevel points towards the septum.

4) Insert airway until flange rests against nostril. If you meet resistance, try the other nostril. DO NOT FORCE IT.
When must you NOT use a nasopharyngeal airway?
Do not use a nasopharyngeal airway in the case of a severe head injury, ESPECIALLY when you can see clear cerebrospinal fluid coming from nose or ears.
Define "suctioning."
Use of a vacuum device to remove blood, vomitus, and other secretions or foreign materials from the airway.
What are the four components of any suctioning device?
A suction source, a collection container, tubing, and suction tips or catheters
What are the two most basic classifications of suctioning units?
Mounted suction systems and portable suction units.
Before operating a suction unit, you must have:
Tubing, suction tips, suction catheters, a collection container, and a container of clean water
What is the most popular type of suction tip?
The rigid pharyngeal tip, also known as the Yankauer, tonsil sucker, or tonsil tip.
Why must you be careful when suctioning the pharynx?
Because you might trigger additional vomiting, and you might trigger the vagus nerve in the back nof the pharynx, thus slowing the heart rate.
What are the primary rules of suctioning?
1) always use infection control measures. Gloves required, eye and face protection recommended.

2) Try to limit suctioning to 15 seconds or less at a time. However, you must also continue suctioning until a patient stops vomiting.

3) Place the tip where you want to begin suctioning and suction as you pull the tip out.
If no spine injury is suspected, what position should the patient's head be in during suctioning?
On its side.
Why must you avoid prolonged suctioning?
Excessive suctioning will cause hypoxia and death.
If using a flexible suction catheter, how do you measure the proper length?
Measure from patient's earlobe to corner of patient's mouth.
What percent oxygen does the atmosphere provide?
21%
What conditions will require oxygen?
Respiratory arrest, cardiac arrest, heart attack, stroke, shock, blood loss, lung diseases, broken bones, head injuries, drug overdose, severe chest injuries, and more.
Define "hypoxia."
An insufficiency of oxygen in the body's tissues.
Most oxygen delivery systems include what three key components?
Oxygen cylinder, pressure regulator, and delivery device (nonrebreather mask or cannula)
A full oxygen cylinder should read a pressure of ___ psi.
2000-2200
What are the five common oxygen cylinder sizes, and what are their oxygen capacities?
D cylinder: 350 liters
E cylinder: 625 liters
M cylinder: 3000 liters
G cylinder: 5300 liters
H cylinder: 6900 liters
What three sizes of oxygen cylinders would you find used in fixed systems on an ambulance?
M, G, H
What colors on an oxygen cylinder let you know that it does indeed contain oxygen?
Green, white, stainless steel.
What is the safe residual pressure reading on an oxygen cylinder?
200 psi. Below this level, oxygen delivery systems cannot operate properly.
What safety rules must you follow when using oxygen cylinders?
1) always use gauges, regulators, and tubing intended to be used with oxygen.

2) Always use nonferrous metal oxygen wrenches. These are non-spark wrenches.

3) Always ensure that valve seat inserts and gaskets are in good condition. Be sure to replace disposable gaskets with every use.

4) Always use medical-grade oxygen labeled "OXYGEN USP" that is less than 5 years old.

5) always open oxygen valve fully then turn back a half turn to prevent others from mistakenly trying to force it open,

6) always have reserve oxygen stored in a cool, dry place, securely fastened,

7) Never drop a tank, always have it secured.

8) never leave a tank standing upright.

9) No smoking!

10) no open flames!

11) keep grease/oil/petroleum products away from tanks

12) do not move tanks by dragging or rolling
How do you calculate the flow time of an oxygen tank?
Subtract the safe residual from the current pressure. Multiply the difference by the appropriate tank constant. Divide that by 10
What are the cylinder constants?
D=0.16
E=0.28
M=1.56
G=2.41
H=3.14
K=3.14
Define "pressure regulator."
A device connected to an oxygen cylinder to reduce cylinder pressure to a safe amount for delivery of oxygen to a patient.
How do pressure regulators attach to oxygen cylinders size E or smaller?
Using a yoke assembly with pins and holes.
How do pressure regulators attach to oxygen cylinders size M and larger?
Using a threaded outlet.
What should you do before attaching a pressure regulator to the valve on an oxygen cylinder?
Crack the valve for a moment to clear any dirt.
Define "flowmeter."
A valise that indicates the flow of oxygen in liters per minute.
What are the three major types of flowmeter?
Bourdon gauge (durable and useable in most situations), pressure-compensated flowmeter (accurate but delicate and must be upright), constant flow selector valve
What is the main drawback of using a Bourdon gauge flowmeter?
Any blockages or kinks will result in a higher than actual reading.
What extremely rugged flowmeter is gaining in popularity?
Constant flow selector.
Define "humidifier."
A device connected to the flowmeter to add moisture to the dry oxygen coming from an oxygen cylinder.
Why use a humidifier when administering oxygen?
Inhaling humidified oxygen is more comfortable for patients, especially for children and patients with COPD.
Why aren't humidifiers used widely on ambulances?
Because they're an infection risk and generally unnecessary for short trips.
What are the nonmedical hazards of using oxygen?
1) Pressurized tanks can become explosives or missiles when damaged. They can be deadly.

2) Oxygen supports combustion and makes fires burn more rapidly.

3) Under pressure, oxygen and oil don't mix. When combined, they can essentially explode. DO NOT USE petroleum-based lubricants or adhesives (tape) around oxygen.
What are the medical hazards of oxygen?
1) Oxygen toxicity or air sac collapse (extremely rare in the field)

2) Infant eye damage

3) Respiratory depression or respiratory arrest.
What are the steps to preparing an oxygen delivery system?
1) Select desired cylinder, check for label "Oxygen U.S.P."

2) Place the cylinder in upright position and stand to one side.

3) Remove plastic wrapper or cap protecting the cylinder outlet.

4) Keep the plastic washer (some setups)

5) Crack the main valve for one second.

6) Select the correct pressure regulator and flowmeter.

7) Place the cylinder valve gasket on the regulator oxygen port.

8) Make sure that the pressure regulator is closed.

9) Tighten t-screw on pin yoke, or tighten threaded outlet with nonferrous wrench.

10) Attach tubing and delivery device
What are the steps to administering oxygen?
1) Explain to the patient the need for oxygen.

2) Open the main valve, adjust flowmeter.

3) Place an oxygen delivery device on the patient.

4) Adjust flowmeter

5) Secure cylinder during transfer
What are the steps to discontinuing oxygen?
1) Remove the delivery device

2) Close the main valve
Define "nonrebreather mask."
A face mask and reservoir bag device that delivers high concentrations of oxygen. The patient's exhaled air escapes through a valve and is not rebreathed.
What's the best device for delivering high concentrations of oxygen to a breathing patient?
Nonrebreather mask
What are the appropriate flow rates for the various oxygen delivery devices?
1) Nonrebreather mask: 12-15 LPM

2) Nasal cannula: 1-6 LPM

3) Venturi mask: Varied, up to 15 LPM
What are the oxygen concentrations for the various oxygen delivery devices?
1) Nonrebreather mask: 80-90%

2) Nasal cannula: 24-44%

3) Venturi mask: 24-60%
How do you inflate a rebreather bag?
After hooking up to oxygen and starting flow at 12-15 LPM, cover the exhaust port or the connection between the mask and reservoir
What types of patients will need more oxygen than a nasal cannula can provide?
Patients with chest pain, shock, hypoxia, or other more serious problems (really any patient with inadequate breathing)
What special considerations must be taken into account when administering oxygen and clearing the airway?
1) Facial injuries: massive bleeding may require an airway adjunct and plenty of suctioning

2) Obstructions: sometimes obstructions are so large that they must be cleared using manual techniques such as abdominal thrusts, chest thrusts, or finger sweeps.

3) Dental appliances: Leave dentures and partials in place in possible since they give form to the face, but remove if they endanger the airway.
How much should you tighten the regulator onto the oxygen cylinder?
Only hand-tight, in case of any malfunctions of the air cylinder, or in case the cylinder runs out and you need to quickly disconnect it.
How can you remember what percentage of oxygen is being administered by a nasal cannula?
At 1 LPM, a nonrebreather mask will deliver 24% oxygen. For every additional LPM,add 4% oxygen, up to 6 LPM (for a maximum of 44% oxygen)
What do you do when you hear gurgling?
Suction! Fast!
What's an NPA?
Nasopharyngeal airway.
define bronchoconstriction.

when is this common?
Is this in the upper or lower airway?
the contraction of smooth muscle that lines the bronchial passages that results in a decreased internal diameter of the airway and increased resistance to air flow.
Common in diseases like asthma.
In the lower airway.
What can happen to a patient when he loses muscle tone in his airway? What can cause this?
(possibly due to altered mental status and neurological disorders)

Tongue relaxes and falls back, which causes the epiglottis to fall back and cover the entrance of the trachea. Obstructs the airway.
Two questions you must consider when assessing a patient's airway:
Is the airway open?

Will the airway stay open?
Define stridor.
high-pitched sound generated from partially obstructed air flow in the upper airway.

can be present on inhalation or exhalation.
What are signs - especially in children - of inadequate breathing?
retractions (pulling in of the muscles) above clavicles and between and below the ribs.
nasal flaring
A partially obstructed airway can cause what sounds?
Stridor - severely restricted in upper airway. nearly complete obstruction
Hoarseness - narrowing of upper airway. voice changes are useful in reassessment of airway issue.
Snoring - decrease in mental status can cause diminished airway muscle tone, so soft tissue of upper airway impedes airflow. airway needs assistance to stay open.
gurgling - fluid obstructing. immediate suctioning.
what is the most common impediment to an open airway?
lack of airway muscle tone.
while opening the airway, what equipment must you ready for immediate use?
suction unit to clear the airway if necessary.
When can you not use an OPA?
OPA can only be used when gag reflex not present. Gag reflex may reappear as a patient regains consciousness. But patient may be able to tolerate NPA instead.
Rules to inserting OPA.

(used when airway is opened, this helps maintain airway)
Have suction ready.
Wear gloves, mask and goggles.
Open airway manually first.
Don't push tongue into pharynx.
Maintain head-tilt or jaw-thrust when adjunct in place.
Remove immediately if regains consciousness or gag reflex.
What to do in reduced LOC but intact gag reflex?
when else would you use this?
Use NPA instead of OPA.
Or use when teeth clenched, or oral injuries.
When do you NOT use NPA?
If CSF coming from EARS or nose. indicates skull fracture. really don't use when head injury suspected.
to be effective, suction devices must furnish an air intake....
air take > 30 L/min at open end of collection tube
(must generate vacuum of >300 mmHg when tube is clamped).
What are suction catheters used for?

Describe measurements.
Not large enough for vomitus or thick secretions. Used when rigid tip cannot be used. It can be passed through OPA, NPA, or endotracheal tube.
(bulb suction can also be used to suction nasal passages).

larger the number, larger the catheter. "14 french" is larger than "8 french"
special considerations in airway management?
1. facial injuries. frequent suctioning may be required for all the bleeding. consider airway adjunct or endotracheal tube.
2. obstruction. suctioning will probably not work for larger things. use abdominal thrusts, chest thrusts or finger sweep.
3. dental appliances - leave denture in place unless it endangers airway.