Airway Flashcards
OPA Measure
Bottom of Earlobe to the corner of the mouth. Along the curvature of the jaw.
NPA Measure
Bottom of the Airway to the corner of the mouth along the curvature of the jaw.
When do you assist ventilations with a BVM
Less than 10 or greater than 30 you would use a BVM to force air in. Unless it’s hyperventilation. Pt needs to calm down in that situation.
When do you not tube a patient?
When the underlying cause can be quickly reversed. Such as Heroin OD (Narcan/Nalaxone .4-2.0 mg) or Hypoglycemia (D50 25g adult, Peds .5mg kg Glucagon 1mg Peds .03mg). Or a patient has a gag reflex.
Contraindications of nasal intubation
Pt has facial injury or is apnea. Color wont’t change on color metric device via nasal tube.
Ways to confirm tube placement
Condensation, equal rise and fall, color metric, auscultation and CAPNOGRAPHY (definitive)
Capnography Measures & Values
CO2 Expulsion. Value should be 35-40
What does a 10 mean on Capnography?
What does a 70 Mean on Capnography?
10 Means they are not exhaling as much
70 means they are exhaling a lot.
Wheezes Loacation, cause & noise?
lower airway, bronchoconstriction, musical sound (test description)
What is the difference between the Upper & Lower Airway?
The glottic opening
Rhales/Crackles
Lower Airway, fluid in lungs(aveoli) Popping/ Rubbing noise/sensation. (Test description)
Stridor
Upper Airway Narrowing of the glottic opening (edema). High pitched whistling (test description)
Best treatment/My Treatment
Best treatment possible available to me as the paramedic.
Definitive Treatment
Best treatment to a patient via the hospital or specialist. Usually out of my scope of practice as a medic
Respiratory Cycle
Inhalation is active
Expiration is passive
What does Asthma do to the respiratory cycle?
It prolongs expiration
Respiratory patients in distress require what treatment other than medicine?
Positioning is a treatment! HIGH FOWLERS
ASHTMA & COPD S/S TREATMENT?
Wheezing(lower airway bronchoconstriction)
Give albuterol or atrovent (ipatropium bromide) if still not working give Epi Sub Q 1:1000 .3-.5 mg then corticosteroids are the next option(medics don’t give) prednisone or solumetrol.
CHF S/S
SOB, wet lung sounds (rhales/crackles fluid in lungs, popping/rubbing sensation/noise)
CHF Treatment with Good Presentation (good BP/Skin Signs etc.)
CPAp is best O2 treatment.
Meds- Nitro (.4mg with good BP) then lasiks (20-40mg for patients not taking lasiks. 40-80 for patients taking lasiks Peds 1mg/kg).
CHF Treatment Poor Presentaion (cool, pale, diaphoretic poor BP etc)
CPAP
Best Med is Dopamine (5-10mcg to increase cardiac output, 10-20mcg to increase vasocontriction)
What is the difference between Allergic Reaction and Anaphylaxis Shock?
The patient in Anaphylaxis is in SHOCK. Has a poor BP! INADEQUATE TISSUE PERFUSION
Person is having an allergic reaction what do you give?
1000% of the time you give Benadryl (25-50mg Peds 1mg/kg).
Epi for Allergic Reaction
vs.
Anaphylaxis Shock
Allergic-Give SuB Q for Beta Properties (.3mg-.5mg Peds .01mg)
Anaphylaxis Shock- Give IV (.1-.3mg Peds .01mg)
Pneumonia S/S
Low Grade Fever, productive cough, yellow brown sputum (100% pneumonia) TEST DEFINITION. Window dressing: SOB, pleuritic chest pain, Slow onset.
Pneumonia Treatment
Definitive Treatment-ANTIBIOTICS
Medic- only give bronchodialators if wheezing
CPAP-if pt. has increased work of breathing
Pink Puffers
COPD-Emphysema looking pt’s. Tweeker looking. Polycythemia due to increased RBC is bodies natural reaction to being constantly o2 deprived. Blood doping
Blue Bloaters
Chronic Bronchitits(test will try to confuse you with pneumonia difference is no fever remember skin signs). Pt’s are cyanotic b/c of hypoxia, lethargic overweight
Nasal Canula
23-44% O2
Simple Mask (NRB w/o Bag)
40-60% O2
NRB
65-95% O2
BVM w/O2
100% only way to give 100% O2
Fresh Water Drowning
The body is more salty than fresh water. The fluid that enters the lungs will be pulled into the interstitial space. Pulling the water out of the lungs
Salt Water Drowning
Water will be pulled from the interstitial space causing the lungs to fill up with more fluid
Wet Drowning
Outside water actually gets into the lungs causing drowning
Dry drowning
The glottic opening spasms shut as a protective measure to prevent fluid from entering the lungs. But in turn kills you because it cuts off your airway
Burns
Airway is number 1 concern. Any swelling of mouth or airway means tube IMMEDIATELY! A SOOT is a good sign
Aerobic Respiration
requires O2
Anaerobic Respiration
no O2 is required
Pulmonary Embolism S/S
SOB, pleuritic CP, no cough, no fever.
Recent Surgery w/ SOB 100% think PE
CO2 Poisoning S/S & Tx
Flushing/red skin, ALOC
High Flow O2, Supportive measures
Definitive Tx- Hyperbaric Chamber
Kussmal Respirations
Angry deep rapid caused by conditions such as DKA that produce Metabolic Acidosis
Central Neurogenic Respirations
Deep Rapid Respirations caused by Strokes or Brainstem Injuries. Loss of ventilatory control & respiratory alkalosis
Atax/Biots Respirations
Repeted gasping ventilation followed by periods of apnea. ICP
Apneustic Respirations
Long DEEP breaths that are stopped during inspiratory phase and seperated by periods of Apnea. Caused by STROKE or CNS disease
Cheyne Stokes Respirations
Progressively increasing then declining followed by periods of apnea. Older patients w/terminal illness or Brain Injury
