Airway Management (Ch. 11) Flashcards
Aerobic metabolism
Metabolism that can proceed only in the presence of oxygen
Aerosol- generating procedure
Any airway manipulation that induces the production of aerosols that may present a risk for airborne transmission of pathogens; such as a CPR.
Atonal gasps
Abnormal breathing pattern characterized by slow, gasping breaths, sometimes seen in patients in cardiac arrest.
Airway
The upper airway tract or the passage ABOVE the larynx, which includes the nose, mouth, and throat.
Alveolar Minute Volume
The volume of air moved through the lungs in 1 minute minus the dead space; calculated by multiplying tidal volume (minus dead space0 and respiratory rate.
Alveolar Ventilation
The volume of air that reaches the alveoli, it is determined by subtracting the amount of dead space air from the tidal volume.
Anaerobic metabolism
The metabolism that takes place in the absence of oxygen; the main by-product is lactic acid.
Apnea
The absence of spontaneous breathing
Apneic oxygenation
A technique in which oxygen administered via a high-flow nasal cannula is left in place during intubation attempt, allowing for continuous oxygen delivery into the airways during all phases of the procedure.
Aspiration
In the context of the airway, the introduction of vomitus or other foreign material into the lungs.
Ataxic respirations
Irregular, ineffective respirations that may or may not have an identifiable pattern.
Bag-mask device
A device with a one-way valve and a face mast attached to a ventilation bag; when attached to a reservoir and connected to oxygen, it delivers more than 90% supplemental oxygen.
Barrier device
A protective item, such as a pocket mask with a valve, that limits exposure to a patient’s body fluids.
Bronchioles
Subdivision of the smaller bronchi in the lungs; made of smooth muscle and dilate or constrict in response to various stimuli.
Capnography
A noninvasive method to quickly and efficiently provide information on a patient’s ventilatory status, circulation, and metabolism. It effectively measures the concentration of carbon dioxide in expired air over time.
Capnometry
The use of a capnometer, a device that measures the amount of expired carbon dioxide.
Carina
Point at which the trachea bifurcates into the left and right main stem bronchi
Chemoreceptors
Monitors the levels of oxygen, carbon dioxide, and pH of the cerebrospinal fluid and then provide feedback to the respiratory centers to modify the rate and depth of breathing based on the body’s needs at any given time.
Cheyne-Stokes respirations
A cyclical pattern of abnormal breathing that increases and then decreases in rate and depth, followed by a period of apnea.
Compliance
The ability of the alveoli to expand when air is drawn in during inhalation
Continuous Positive Airway Pressure (CPAP)
A method of ventilation used primarily in the treatment of critically ill patients with respiratory distress, can prevent the need for endotracheal intubation
Dead space
Any portion of the airway that does contain air and cannot participate in gas exchange, such as the trachea and bronchi.
Diffusion
Movement of a gas from an area of higher concentration to an are of lower concentration.
Dyspnea
Shortness of breath
Endotracheal (ET) Intubation
Insertion of an ET tube directly through the larynx between the vocal cords and into the trachea to maintain and protect an airway.
End-Tidal CO2
The amount of carbon dioxide present at the end of an exhaled breath.
Esophageal intubation
improper placement of an advanced airway device into the esophagus rather than the trachea
Exhalation
the passive part of the breathing process in which the diaphragm and the intercostal muscles relax, forcing air out of the lungs
external respiration
the exchange of gases between the lungs and the blood cells in the pulmonary capillaries; also called pulmonary respiration
gag reflex
a normal reflex mechanism that causes retching; activated by touching the soft palate or the back of the throat.
gastric distension
a condition in which air fills the stomach, often as a result of high volume and pressure during artificial ventilation.
glottis
the space between the vocal cords that is the narrowest portion of the adult’s airway; also called the glottic opening.
good air exchange
a term used to distinguish the degree of distress in a patient with a mild airway obstruction. With good air exchange, the patient is still conscious and able to cough forcefully, although wheezing may be heard.
head tilt-chin lift maneuver
a combination of two movements to open the airway by tilting the forehead back and lifting the chin; NOT used for trauma patients.
hemothorax
a collection of blood in the pleural cavity
hypercarbia
increased carbon dioxide level in the bloodstream
hypoxia
deficient oxygen concentration
hypoxic drive
a “backup system” to control respiration; senses drops in the oxygen level in the blood
inhalation
the active, muscular part of breathing that draws air into the airway and lungs
internal respiration
the exchange of gases between the blood cells and the tissues
intrapulmonary shunting
bypassing of oxygen-poor blood past nonfunctional alveoli to the left side of the heart
jaw-thrust maneuver
technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used for patients who may have a cervical spine injury
labored breathing
the use of muscles of the chest, back, and abdomen to assist in expanding the chest; occurs when air movement is impaired
larynx
a complex structure formed by many independent cartilaginious structures that all work together; where the upper airway ends and the lower airway begins; also called the voice box
See pg. 420
mediastinum
space within the chest that contains the heart, major blood vessels, vagus nerve, trachea, major bronchi, and the esophagus located between the two lungs.
metabolism
the biochemical processes that result in production of energy from nutrients within the cells; also called cellular respiration
mild airway obstruction
occurs when a foreign body partially obstructs the patient’s airway. the patient is able to move adequate air but also experiences some degree of respiratory distress
minute volume
the volume of air that moves into and out of the lungs per minute; calculated by multiplying the tidal volume and respiratory rate; also called minute ventilation
nasal cannula
an oxygen-delivery device in which oxygen flows through two smalls, tubelike prongs that fit into the patient’s nostrils; delivers 24% to 44% supplemental oxygen, depending on the flow rate.
nasopharyngeal (nasal) airway
airway adjunct inserted into the nostril of an unresponsive patient or a patient with an altered level of consciousness who is unable to maintain airway patency independently
nasopharynx
the part of the pharynx that lies above the level of the roof of the mouth, or palate
nonrebreathing mask
a combination mask and reservoir bag system that is the preferred way to give oxygen in the prehospital setting; delivering up to 90% inspired oxygen and prevents inhaling the exhaled gases (carbon dioxide)
oropharyngeal (oral) airway
airway adjunct inserted into the mouth of an unresponsive patient to keep the tongue from blocking the upper airway and to facilitate suctioning the airway, if necessary
oropharynx
a tubular structure that forms the posterior portion of the oral cavity, which is bordered superiorly by the hard and soft palates, laterally by the cheeks, and inferiorly by the tongue
oxygenation
the process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs
oxygen toxicity
a condition of excessive oxygen consumption resulting in cellular and tissue damage
parietal pressure
the term used to describe the amount of gas in air or dissolved in fluid, such as blood
passive ventilation
the act of air moving into and out of the lungs during chest compression
patent
open, clear of obstruction
phrenic nerves
the two nerves that innervate the diaphragm; necessary for adequate breathing to occur
pneumothorax
an accumulation of air or gas in the pleural cavity
poor air exchange
a term used to describe the degree of distress in a patient with a mild airway obstruction with. with poor air exchange, the patient often has a weak, ineffective cough, increased difficulty breathing, or possible cyanosis and may produce a high-pitched noise during inhalation (stridor)
preoxygenation
the process of providing oxygen, often in combination with ventilation prior to intubation in order to raise the oxygen levels of body tissues; a critical step in advanced airway management. this extends the time during which an advanced airway can be placed in an apneic patient, because the more oxygen that is available in the alveoli, the longer the patient can maintain adequate gas exchange in the lungs during the procedure
Pulse Oximetry
an assessment tool that measures oxygen saturation of hemoglobin in the capillary bed
recovery position
a side lying position used to maintain a clear airway in unconscious patients without injuries who are breathing adequately
residual volume
the air that remains in the lungs after maximal expiration
respiration
the process of exchanging oxygen and carbon dioxide
retractions
movements in which the skin pulls in around the ribs during inspiration
severe airway obstruction
occurs when a foreign body completely obstructs the patients airway. the patient cannot breathe, talk, or cough.
stoma
an opening through the skin and into an organ or other structure
stridor
a harsh, high-pitched respiratory sound, generally heard during inspiration, that is caused by partial blockage or narrowing of the upper airway; may be audible without stethoscope
suction catheter
a hollow, cylindrical device used to remove fluid from the patients airway
tension pneumothorax
an accumulation of air or gas in the pleural cavity that progressively increases pressure in the chest and that interferes with cardiac function, with potentially fatal results
tidal volume
the amount of air (in mL) that is moved into or out of the lungs during one breath
tracheotomy
a surgical procedure to create an opening (stoma) into the trachea; a stoma in the neck connects the trachea directly to the skin
ventilation
the exchange of air between the lungs and the environment; occurs spontaneously by the patient or with assistance from another person; such as an EMT
visceral pleura
thin membrane that covers the lungs
vital capacity
the amount of air that can be forcibly expelled from the lungs after breathing in as deeply as possible
vocal cords
thin white bands of tough muscular tissue that are lateral borders of the glottis and serve as the primary center for speech production
wheezing
a high pitched whistling breath sound that is most prominent on expiration, and which suggests an obstruction or narrowing of the lower airways; occurs in asthma and bronchiolitis
