Term
| The most important step for caring for a patient |
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Definition
To make sure that he or she can breathe.
Oxygen reaches vody tissues and cells through two separate but related processes: breathing and circulation |
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Term
| Structures that help us breath |
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Definition
| The diaphragm, The muscles of the chest wall, Accessory muscles of breathing, and the nerves from the brain and spinal cord to those muscles |
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Term
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Definition
| Is the exchange of air between the lungs and environment |
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Term
| What are responsible for the regular rise and fall of the chest that accompany normal breathing? |
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Definition
| The diaphragm and muscles of the chest wall. |
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Term
| What is the air way divided into? |
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Definition
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Term
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Definition
| The UPPER consists of the nose, mouth, throat (pharynx), and a structure called he epiglottis, The portion of the throat behind the nose is the nasopharynx; the portion behind the mouth is the oropharynx. |
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Term
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Definition
| The LOWER begins with the larynx (voice box), the trachea, main bronchi, smaller bronchi, and the alveoli (where the exchange of oxygen and carbon dioxide occur) |
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Term
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Definition
| a firm cartilage ring that forms the lower part of the larynx |
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Term
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Definition
| directly connected to the larynx beneath it |
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Term
| The main bronchi and smaller bronchioles |
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Definition
| They branch off from the trachea extending into each lung. The smaller bronchioles end in the alveoli |
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Term
| The space between the lungs is called what? |
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Definition
| The mediastinum. This is surrounded by tough connective tissue. |
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Term
| The mediastinum space contains |
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Definition
| the heart, great vessels, the esophagus, the trachea, the major bronchi, and many nerves |
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Term
| What are the boundaries of the thorax? |
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Definition
| The rib cage anteriorly, superiorly, and posteriorly and the diaphragm inferiorly |
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Term
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Definition
| A skeletal muscle because it is attached to the costal arch and the vertebrae. It functions both as voluntary and involuntary muscle |
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Term
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Definition
| The active muscular part of breathing |
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Term
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Definition
| A measure of the depth of breathing, is the amount of air that is moved during one breath. |
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Term
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Definition
| Does not require muscular effort. During exhalation, the diaphragm and the intercostal muscles relax. In response the thorax decreases in size and the ribs and muscles assume a normal resting position |
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Term
| Clearing the airway means what? |
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Definition
| removing obstruction material, tissue, or fluids fromt ehnose, mouth or throat. Maintaining the airway means keeping the air way open |
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Term
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Definition
| Cells taking energy from the nutrients through a series fo chemiacl processes |
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Term
| How many minutes can brain cells and cells in the nervous system last before permanently damageing occurs or they die? |
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Definition
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Term
| Kidney cell's can last how many minutes with out oxygen and still survive |
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Definition
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Term
| Normal air we breath contains how much oxygen and how much nitrogen? |
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Definition
| 21% oxygen, and 78% nitrogen, 1% are small amounts of other gasses |
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Term
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Definition
| A passive process in which molecules move from an area with higher concentration of molecules to an area of lower concentration |
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Term
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Definition
| Molecules of oxygen move from the alveoli into the blood because there are fewer oxygen molecules in the blood. Molecules of arbon dixide move from the blood into the alveoli because there are fewer carbon dioxide molecules in the alveoli. |
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Term
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Definition
| in the alveoli it produces a chemical called surfactant that makes the diffusion of carbon dioxide and oxygen much faster more efficient |
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Term
| What happens if surfactant is removed |
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Definition
| it cause's acute repiratory distress. EX. such as water from a drowning |
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Term
| Air that we exhale contains |
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Definition
16% oxygen and 3 to 5% carbon dioxide, the left over 79% is nitrogen.
When providing rescue breathing on someone who is not breathing the patient is recieving 16% concentration of oxygen with each of your exhaled breaths. |
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Term
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Definition
| In a healthy person the stimulus to breathe |
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Term
| When the level of carbon dioxide becomes to high what occurs? |
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Definition
| The brain stem sends nerve impulses down the spinal cord that cause the diaphragm and the intercostal muscles to contract. This increases our breathing or respirations. |
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Term
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Definition
| to control respiration called HYPOXIC DRIVE. This system stimulates breathing when oxygen levels fall (hypoxia) |
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Term
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Definition
| an extremely dangerous condition inwhich the bodys tissues and cells do not have enough oxygen. Hypoxia develops quickly in the vital organs of patients who are noth breathing adequately, as well in those who are not breathing at all. |
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Term
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Definition
| means that the person cannot move enough air into the lungs with each breath to meet the bodys needs. |
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Term
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Definition
| May include mental status changes, the use of accessory muscles for breathing, difficulty breathing, possible chest pain, and late in the process cyanosis |
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Term
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Definition
| Nervousness, irritability, apprehension, fast heart rate(tachycardia), and fear |
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Term
| Conscious patients of Hypoxia will complain of |
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Definition
| shortness of breath and may not be able to talk in complete sentences. The best time to give a patient oxygen is before any symtoms occur |
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Term
| What are the conditions commonly associated with hypoxia? |
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Definition
| Heart attack, Pulmonary edema, Acute narcotic overdose, Inhalation of smoke or toxic fumes, Stroke, Chest injury, Shock, Chronic obstructive pulmonary disease, Asthma |
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Term
| Signs of normal breathing for adult patients are |
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Definition
| 12 and 20 breaths per min for an adult, a regular pattern of inhalation and exhalation, Clear and equal lung sounds on both sides of the chest, regular and equal chest rise and fall(chest expansion), adequate depth (tidal volume) |
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Term
| Normal respiration for an adult |
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Definition
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Term
| normal respiration for a child |
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Definition
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Term
| normal respiration for infants |
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Definition
| 30 to 60 breaths per min. |
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Term
| What should you always have at hand? |
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Definition
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Term
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Definition
| Working hard to breathe. It requires effort and especially among children may involve the accessory muscles. Secondary muscles of respirtion include the neck muscles (sternocleidomastoid), The chest pectoralis major muscles, and the abdominal muscles |
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Term
| Signs of inadequate breathing in adult patients are what? |
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Definition
| Respiratory rate of less than 8 breaths a min or greater than 24 breaths a min, accessory muscle use, skin pulling in around the ribs during inspiration, pale, cyanotic, or cool skin, irregular pattern of inhalation and exhalation, lung sounds that are decreased, unequal or wet, lavored breathing, shallow and or uneven chest rise and fall, two or three word sentences spoken |
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Term
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Definition
| The patient may appear to be breathing after the heart has stopped. Agonal resprations occur when the respiratoy center in the brain continuse to send signals to the breating muscles |
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Term
| Cheyne-Stokes respirations |
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Definition
| an irregular repiratory pattern in which the patient breathes with an increasin rate and depth of respiration that is followed by a period of APNEA ( lack of spontaneous breathing, followed again by the pattern of increasing rate and depth |
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Term
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Definition
| includes airway management, supplemental oxygen and ventilatory support. |
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Term
| What does Emergency care begin with |
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Definition
| Ensuring an open apen airway. The patients airway and breathing status are teh first steps in your initial assessment |
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Term
| When you respond to a call and find an unconscious patient, what do you do? |
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Definition
| You need to assess and determine immediately whether the patient has an open airway and breathing is adequate. |
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Term
| What position does the patient need to be in to assess there breathing |
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Definition
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Term
| What are the steps of being log rolled as a unit if you find your patient is the prone(lying face down) position? |
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Definition
| Read pages 194 steps and become sure with doing this procedure |
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Term
| Head tilt-chin lift maneuver |
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Definition
| Tilt the patients head back and lifting the chin. ONLY IF PATIENT IS NOT SUSPECTED OF SPINAL TRAUMA |
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Term
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Definition
| Use if suspected cervical spine injury. Its a techniqued to open the airway by placing the fingers behind the angle of the jaw and lifting the jaw upward |
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Term
| Primary function of an airway adjunct |
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Definition
| to prevent obstruction of the upper airway by the tongue and allow the passage of air and oxygen to the lungs |
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Term
| Oropharyngeal (oral) airway |
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Definition
Two principal purposes.
1. The first is to keep the tongue from blocking the upper airway.
2. The second is to make it easier to suction the airway if necessary.
This type of airway is often used inconjunction with bagvalve-mask (BVM) ventilation |
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Term
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Definition
| A protective reflex mechanism that prevents food and other particles from entering the airway. This may result in vomiting or a spasm of the vocal cords |
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Term
| What are the steps in insertin an oropharyngeal airway |
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Definition
1. Select proper size. Measure the patients earlobe to the corner of teh mouth on the side of the face.
2. Open the patients mouth
3. Rotate the airway 90 degrees or 180 degrees depending on initial placement of the oropharynegeal airway |
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Term
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Definition
| gently remove the airway by pulling it straight out |
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Term
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Definition
| Log Roll patient onto there left side |
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Term
| Nasopharyngeal (nasal or trumpet) airway |
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Definition
usually used with a patient who has an intact gag reflex and is not able to maintain an airway. Make sure you have proper size (measure from the tip of the patients nose to there earlobe).
Lube the airway up with a water-soluble Place the airway in the larger nostril. Advance the airway gently.
When completly inserted the flange should rest against the nostril. |
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Term
| Disadvantages of the nasal airway include teh following |
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Definition
May be contraindicated in severe head or facial trauma
May traumatize delicate nasal membranes, causing bleeding,
May not be able to insert if teh patient has a history of fractured nasal bones |
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Term
| The rule of thumb for when a patient needs suctioning |
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Definition
| If you hear gurgling the patient needs suctioning |
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Term
| A suctioning unit should be fited with what |
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Definition
Wide bore, thick walled, nonkinking tubing
Plastic, semirigid pharyngeal suctiontips, called tonsil tips or yankauer tips
Nonrigid plastic catheters called french or whistle tip catheters
A nonbreakable, disposable collection bottle
A supply of water for rinsing the tips |
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Term
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Definition
| A hollow cylindrical strcture that drains or delivers fluids. Tonsil tips oare teh best kind of catheter for suctioning pharynx in adults and teh preferred method for infandts and children |
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Term
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Definition
| The intoduction of vomit or other foreign material into the lungs |
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Term
| To properly suction a patient |
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Definition
Turn on the assemble suction unit
Insert the catheter to the correct depth
Before applying suction open the patients mouth using the cross finger technique or by pulling the jaw
Apply suction in a circular motion as you withdraw the catheter. Do not suction the adult for more than 15 seconds. |
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Term
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Definition
| Opening in the neck that connects the trachea directly to the skin |
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Term
| French or whistle-tip catheters |
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Definition
| Soft plastic, nonrigid catheters. used to suction the nose and liquid secretions in teh back of the mouth and in situations in which you cannot use a rigid catheter such as for a patient with a stoma |
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Term
| How much should the suctioning unit generate |
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Definition
| a vacuum of more than 300 mm hg. |
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Term
| How long do you suction on adults, children and infants |
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Definition
1. adults no more than 15 sec
2. children no more than 10 sec
3. infants no more than 5 sec
Because it removes oxygen from the airway |
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Term
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Definition
used to help maintain a clar airway in a patient who has not had traumatic injuies and is breathing on his or her own with a normal rate and adequate tidal volume (depth of breathing)
1. Roll the patient onto the left side so that head, shoulders, and torso move at the same time without twisting
2.Place the patients extended left arm and right hand under his or her cheek.
This position is not appropriate for patients with suspected spinal trauma, or patients who are unconscious and require airway management |
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Term
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Definition
| A compressed gas, used for helping patients with breathing. Oxygen cylinders come in various sizes |
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Term
| The two most common sizes that you will most often use are |
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Definition
| the D (or super D) and M cylinders |
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Term
| What cylinder can be used to carry to and fromt the patient |
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Definition
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Term
| What tank do you use on board your unit as a main supply tank |
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Definition
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Term
| What are the sizes of tanks you will see? |
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Definition
| D, Super D, E, M, G, H or A or K |
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Term
| What is the volume of cylinder D? |
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Definition
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Term
| What is the volume of cylinder super D? |
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Definition
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Term
| What is the volume of cylinder E? |
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Definition
|
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Term
| what is the volume of cylinder M? |
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Definition
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Term
| What is the volume of cylinder G? |
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Definition
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Term
| What is tbe volume of cylinders H, A, K? |
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Definition
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Term
| Cylinders are fitted with what in order to make sure that patients receive teh right amount and type of gas? |
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Definition
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Term
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Definition
| It prevents you from putting an oxygen regulator on a carbon dioxide cylinder or the other way around. It is how the regulators are attached |
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Term
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Definition
| the safety system for large cylinders is know as the amercian standard system. In thsi system, cylinders larger than D sizes are equipped with threaded gas outlet valves. It prevents an inproper regulator fit |
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Term
| What is the pressure of a gas in a full oxygen cylinder |
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Definition
| is approzimately 2,000 psi. pressure regulates that psi to a far more safer psi. |
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Term
| The range for a pressure regulators useally are between |
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Definition
| 47 to 70 psi. This is called a single stage regulator. A 2 stage regulator would take the 2000 psi to a 700 psi then to 47 to 70 psi |
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Term
| Pressure-compensated flowmeter |
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Definition
incorporates a float ball with a tapered calibrated tube. The float rises or falls according to the gas flow within the tube.
This type of flowmeter is affected by gravity and must always be used in the upright position. |
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Term
| The Bourdon-gauge flowmeter |
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Definition
| commonly used because it is not affected by gravity and can be used in any postition |
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Term
| Before placing an oxygen cylinder into service |
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Definition
1. Inspect the cylinder
2. Attach the regulator/flowmeter
3. Place the regulator collar over the cylinder valves
4. With the regulator firmly attached open the cylinder and read the pressure level on the regulator gauge. |
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Term
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Definition
| The preferred way of giving oxygen in the prehopital setting. With a good mask to face seal it is capable of providing up to 90% inspired oxygen |
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Term
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Definition
| Delivers oxygen through to small tubelike prongs that fit into the patients nostrils. This device is capable of providing 24% to 44% inspired oxygen |
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Term
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Definition
| a recent assessment tool used to evaluate the effectiveness of oxygenation. the pulse oximeter is a photoelectric device that monitors the oxygen saturation of hemoglobin (the iron-containing portion of the red blood cell to which oxygen attaches) in the capillary beds |
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Term
| What is the normally for a pulse oximetry |
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Definition
| values will be greater than 95% on room air, with the majority being between 98% and 100% |
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Term
| What should the Pulse oximetry always be considered as? |
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Definition
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Term
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Definition
| A protective item that features a plastic barrier placed on a patients face with a one-way valve to prevent the back flow of secretions, vomitus, and gases |
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Term
| Ventilation Rates for Adult, Child, and Infant |
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Definition
1. Adult 1 breath per 5 sec.
2. Child 1 breath per 3 sec.
3. Infant 1 breath per 3 sec. |
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Term
| What are the steps to use mouth to mask ventilation? |
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Definition
1. Kneel at the patients head open the airway using the head tilt-chin lift maneuver or the jaw thrust maneuver if indicatied
2. Take a deep breath and exhale
3. Remove your mouth and watch for the patients chest to fall during passive exhalation |
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Term
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Definition
| With an oxygen reservoir can deliver nearly 100% oxygen. A BVM device should be used when you need to deliver high concentrations of oxygen to patients who are not ventilating adequately. Its used for patients in respiratory arrest, cardiopulmonary arrest, and respiratory failure. It may be used with or without oxygen however the most efficient way is to use it with supp;emental oxygen and a reservoir. Also using a oral or nasal airway adjunct in conjuncion with the BVM device |
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Term
| All adult BVM devices should have the following components |
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Definition
-A disposable self refilling bag
-No pop-off valve, or if one is present, the capability of disabling the pop-off valve
-An outlet valve that is a true valve for nonbreathing
-An oxygen reservoir that allows for high oxygen concentration delivery
-A one-way, no jam inlet valve system that provides an oxygen inlet flow at a maximum of 30L/min with standard 15/22mm fittings for face mask and endotracheal (or other advanced airway adjunct) connection
-A transparent face mask
-Ability to perform under extreme environmental conditions, including extreme heat or cold |
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Term
| What is the total amount of gas in the reservoir bag of an adult BVM device? |
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Definition
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Term
| What does the pediatric bag hold? |
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Definition
|
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Term
| What does the infant reservoir bag hold? |
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Definition
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Term
| Indications that artificial ventilation is adequate |
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Definition
-Equal chest rise and fall with ventilation
-Ventilations delivered at teh approprate rate
-12/min for adults
-20/min for infants and children
Heart rate returns to normal range |
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Term
| Indications taht artificail ventilation is inadequate |
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Definition
-Minimal or no chest rise or fall
-Ventilations are delivered too fast or too slow for patient's age
-Heart rate does not return to normal range |
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Term
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Definition
Pressure on the cricoid cartilage; applied to inhibit gastric distention and aspiration of vomitus in the unconscious patient.
Use this if the patients chest does not rise or fall, |
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Term
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Definition
Inflation of the stomach.
A condition in which air fills the stomach as a result of high volume and pressure during artificial ventilation |
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Term
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Definition
To prevent or alleviate distention
To perform the Sellick maneuver have an additional rescuer apply cricoid pressure on the patient by placing the thumb and index finger on either side of the cricoid cartilage (at the inferior border of the larynx) pressing down. |
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Term
| Flow-restricted, oxygen-powered ventilation devices should have the following components |
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Definition
-A peak flow rate of 100% oxygen at up to 40 L/min
An inspiratory pressure safety release valve that opens at approximately 60 cm of water and vents any remaining volume to the atmosphere or stops the flow of oxygen
-An audible alarm that sound whenever you exceed the relief valve pressure
-The ability to operate satisfactorily under normal and varying environmental conditions
-A trigger (or lever) positioned so that both your hands can remain on the mask to provide an airtight seal while supporting and tilting the patients head and keeping the jaw elevated |
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Term
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Definition
| A partial or complete accumulation of air in the pleural space |
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Term
| Gastric Distention (severe inflation of the stomach is dangerous because what or why? |
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Definition
| may cause vomiting and increase teh risk of aspiration during CPR |
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Term
| What is to be used for patients who have had a laryngectomy (surgical removal of the larynx). These patients have a permanent tracheal stoma (an opening in the neck that connects the trachea directly to the skin? |
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Definition
|
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Term
| Partial airway obstuction |
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Definition
| Condition in which an obstruction leave teh patient able to exchange some air, but also causes some degree of respiratory distress. |
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Term
| Complete Airway obstruction |
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Definition
| Occurs when a foreign body completely obstructs the patients airway. Patients cannot breathe, talk or cough |
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Term
|
Definition
The patient can cough forcefully although you may hear wheezing between coughs.
Always encourage coughing |
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Term
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Definition
| The patient has a weak ineffective (not forceful) cough and may have an increased difficulty breathing, stridor (a high-pitched noise heard primarily on inspiration) and cyanosis |
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Term
| Whats the universal distress signal for choking? |
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Definition
| The personmay clutch or grasp his or her throat |
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Term
| What are possible causes of airway obstruction? |
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Definition
-Relaxation of the tongue in an unconscious patient
-Aspirated vomitus (stomach contents)
-Foreign objects_ food, small toys or dentures
-Blood clots, bone fragments, or damaged tissue after an injury
-Airway tissue swelling_infection, allergic reaction |
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Term
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Definition
| The ability of the alveoli to expand when air is drawn in on inhalation; poor lung compliance is the inability of the alveoli to fully expand on inhalation |
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Term
|
Definition
| discolorations of the skin caused by lack of oxygen in the blood |
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Term
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Definition
| A noninvasive emergency lifesaving care that is used to treat airway obstruction, respiratory arrest, or cardiac arrest. |
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Term
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Definition
-Airway (Obstruction),
-Breathing (Respiratory Arrest)
-Circulation (Cardiac Arrest or Severe Bleeding |
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Term
| Cardiopulmonary resuscitation (CPR) |
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Definition
| Used to establish artificial ventilation and circulation in a patient who isnt not breathing and has no pulse |
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Term
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Definition
-Opening the airway
-Restoring breathing by means of rescue breathing
-Restoring circulation by means of chest compresions to circulate blood through the body |
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Term
| Advanced Life Support (ALS) |
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Definition
| Involves advanced lifesaving procedures, such as cardiac monitoring, administration of IV fluids and medications, and use of advanced airway adjuncts |
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Term
| The abdominal-thrust (Heimlich maneuver) |
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Definition
| Teh preferred way to dislodge and force foodor other material from the throat of a choking victim |
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