Airway Lecture Flashcards
Larynx
Voice box containing vochal cords
What protects the trachea from food and water?
Epiglottis
Two layers of Connective tissue that surround the lung?
The pleura: divided into the visceral and parietal
What is visceral pleura?
Innermost covering layer of lung
What is parietal pleura
Thicker more elastic layer that adheres to the inner portion of chest wall
What is the small space in between the pleura layers?
Pleural space has negative pressure
What happens during inspiration?
Diaphragm/muscles contract
Diaphragm moves Downward
Negative pressure created
Thorax expands
Active component in breathing
What happens on exhalation?
Diaphragm/muscles relax
Increase in pressure in cavity
Passive component of breathing
What is external respiration
gas exchange process that occurs between the alveoli and the surrounding pulmonary capillaries
serves to oxygenate the blood and eliminate carbon dioxide in the lungs
What is internal respiration?
gas exchange process that occurs between the cells and the systemic capillaries
responsible for delivering oxygen to the cells and removing carbon dioxide from the cells
what is cellular respiration?
known as aerobic metabolism, occurs in the cell. The process breaks down glucose in the presence of oxygen, produces high amounts of energy in the form of ATP, and releases carbon dioxide and water as a byproduct.
What is the adequate breath rate for an adult?
12-20/min
what is the adequate breath rate for a pediatric?
15-30/min
what is the adequate breah rate for an infant?
25-50/min
what is adequate breathing?
present and equal breath sounds
adequate and equal chest expansion
minimal work for breathing
What is hypoxia?
inadequate amount of o2 in/being delivered to tissue
What are signs of hypoxia?
Nervousness, irritability, & fear
Tachycardia
Mental status changes
Use of accessory muscles for breathing
Difficulty breathing; possible chest pain
Cyanosis in severe hypoxia cases
what are the causes of airway disruption?
Mechanical: allergic reaction/nerve issue
Disease: pneumonia
obstruction: pulmonary embolism/clots
What are signs of inadequate breathing?
tachypnea/bradypnea
unequal/inadequate chest expansion
accessory muscle use/increased work to breath
poor tidal volume
What are the indications for o2 administration?
-Any patient in cardiac arrest or respiratory arrest
-Any patient who is being ventilated via positive pressure ventilation
-Any signs of hypoxia in a patient with adequate respiratory rate / tidal volume
-Any patient with a SpO2 reading less than 95 percent
-Medical conditions that may cause hypoxia
-Any patient with an altered mental status or who is unresponsive
-Injuries to any body cavity, including head, spine, chest, abdomen, and pelvis
-Multiple fractures and multiple soft tissue injuries
-Severe bleeding that is either external or internal
-Any evidence of hypoperfusion
-Exposure to toxins such as carbon monoxide and cyanide
What are the key points for non rebreather masks
o2 flows at 8-15lpm
reservoir must be filled prior to application
what are the key points for nasal cannula
o2 flows at 2-6lpm
fangs follow cavity and tuck behind ear like glasses
headtilt chin lift vs jawthrust?
head tilt chin lift can be used in non trauma
the jaw thrust is used in trauma/suspected spine damage
What is and why use the recovery position?
patient is on their side in the recumbent position, used to reduce risk of aspiration/choking. trauma pt must remain supine.
how long do you suction for?
15 seconds or until clear
when to use an opa and how to insert it?
patient is unconcious/no gag reflex,
suspected facial trauma
upside down or laterally and then rotate it
how to measure an opa?
Center of mouth to angle of jaw
Corner of mouth to tragus of ear
how to measure an npa?
Length: Tip of nose to bottom of earlobe
Diameter: Consider size of pt’s right nare
how to insert an npa?
Use water soluble gel to lubricate NPA
Insert into pt’s right nare with beveled edge towards septum.
Insert until flange is flush with pt’s nose
contraindications for an npa?
Maxillary trauma
Nasal Trauma
Suspected skull fracture
Resistance encountered during insertion
what are indications for PPV
respiratory arrest
inadequate respiratory effort
inadequate repsiratory rate
bradycardia
cyanosis
What are the key points for PPV
FATS technique for no neck injury
two person technique if neck injury
administer 15-25lpm
always use an adjunct with PPV
What is oxygenation?
a form of respiration in which oxygen moves from a high concentration to a low concentration across a membrane. The process by which cells become saturated with oxygen
What is ventilation?
mechanical process based on changes in pressure inside the chest that causes air to flow into or out of the lungs
What is Respiration?
the exchange of oxygen and carbon dioxide that takes place during inhalation and exhalation
What are pediatric considerations for the airway?
-noses and mouths of infants and children are smaller and more easily obstructed
-tongue of an infant or child is relatively large in proportion to the size of the mouth.
-trachea and lower airway passages of infants and children are narrower, softer, and more flexible than those of adults.
-chest wall in an infant or a child is much softer and more pliable. It is much more compliant to movement during ventilation.
