Airway Review Flashcards
What are abnormal upper airway sounds?
Stridor-high pitched musical sound
How do you assess shortness of breath issues?
Lung sounds
Pulse rate
Spo2
What are abnormal lower airway sounds?
Wheezing-high pitched sound on inspiration, expiration, or both
Rhonchi-low pitched continuous sound resulting from mucus or fluid
Crackles-(rales) airflow causes fluid to move into the lower airways
What issues could arise from facial injuries?
Nasal airways should not be used with any kind of facial bone injuries or basal skull fracture. Blood and teeth in the airway is also a possibility and should be checked.
What are abnormal respiratory patterns?
Cheyne-stokes Kussmaul Biot Apneustic Agonal gasps
Describe cheyne-stokes respirations.
Gradually increasing rate and depth of respirations followed by a gradual decrease of respirations with intermittent periods of apnea
Describe kussmaul respirations.
Deep, rapid respirations. Associated with diabetic ketoacidosis
Describe biot respirations.
Irregular pattern, rate, and depth of breathing with intermittent periods of apnea
Describe apneustic respirations.
Prolonged gasping inhalation followed by short, ineffective exhalation.
How do you treat acute mountain sickness?
Remove them from the area, give positive pressure ventilations, and consider the use of a hyperbaric chamber.
What should you remember regarding stylet use?
Don’t let the end past Murphy’s eye.
Hold the tube in place when you withdraw the stylet.
What is the preferred method for ventilations for an unconscious patient for maximum volume?
Mouth to mask
What do pale, greasy bowel movements indicate?
Cystic fibrosis
What are vesicular sounds?
Heard over most of the lung fields and are the major normal breath sound. They are low pitched and soft.
What are bronchial sounds?
Heard only over the trachea. Highest in pitch.
What are bronchivesicular sounds?
Heard over the major bronchi and are louder than vesicular sounds. Considered to be medium pitch.
Where does pneumonia rank in the geriatric community?
fourth
How do you treat snoring?
Head tilt chin lift or jaw thrust.
Check airway for partial obstructions.
When should you place an NPA instead of an OPA? And vice versa?
Do not place an NPA with a basalar skull fracture or facial injuries.
Do not place an OPA with an intact gag reflex.
What is a complication of sedating for intubation?
Aspiration and hypotension
What should you be careful of when extubating?
Laryngospasm
What is a common respiration pattern with increased ICP?
Ataxic Biots
What action does albuterol have?
Bronchodilation
What are the sizes of ET tubes?
2.5-9.0
Adults: 5.0-9.0 cuffed
Pedi: 2.5-4.5 uncuffed
What is the normal ET tube size for men? And women?
Men: 8.0
Women: 7.5
You can go up or down .5 in either direction for different size patients.
Why and when does cor pulmonare occur?
It occurs with emphysema because it destroys capillaries.
When is the glottic opening the largest?
Inspiration
What are the contraindications for an automatic transport ventilator in an emergency transport?
Children under 5
What will a pulmonary embolism do to the heart? And what is a sign of that?
It causes blood to back up to the right side of the heart.
JVD is a sign
What are indicators of appropriate ventilations?
Equal chest rise
Change in skin color
Increased spo2
What are cheyne-stokes respirations a sign of?
Brain stem injury
What does a BVM not need to function?
O2 supply
If a patient presents with increased co2 and o2 is good, what should you do?
Increase ventilations
What does Lou Gehrig’s disease present with?
Patient unable to thrive or talk
What impact does rib fracture have on breathing?
Less diffusion
What are complications of needle cric?
Barotrauma due to overinflation
Bad placement Bleeding Laceration of jugular vein Damage to thyroid gland Damage to vagus nerve
What is the procedure for nasal intubation?
Oxygenate the patient while tube is lubricated.
Insert tube into largest nostril.
Palpate the larynx while listening for air flow over the tube.
Ventilate the patient and confirm placement.
What does Cushings disease result from?
Long term corticosteroid use
How do you treat hyperventilation syndrome?
Coach them to calm down and slow ventilations
How do you clear a stoma?
Soft tip catheter suction
What are the side effects of an inhaler?
Tachycardia
Hypertension
Dysrhythmias
What kind of problem is muscular dystrophy?
Nerve problem
What’s the difference between pneumothorax and bronchitis?
Pneumothorax will have absent or diminished lung sounds on one side
What is FIO2?
Fraction of inspired o2 content
What causes stridor?
Upper airway swelling or partial obstruction
How do you treat ARDS?
Use anti inflammatory drugs
Or corticosteroids
What are the signs and symptoms of pneumonia?
High Fever
Pleuritic chest pain
Productive cough
With shortness of breath, what would the pulse be like in adults? And children?
Tachycardic
For children, tachycardic then bradycardic quickly
If you hear fluid in the bases of the lungs, what does that indicate?
Probably aspirated pneumonia.
What breath sound would you hear if the patient had pulmonary edema?
Crackles
What are key differences between chronic bronchitis, bronchitis, and pneumonia?
Chronic bronchitis - no fever
Bronchitis - inflammation, fever, greenish phlegm
Pneumonia - brown sputum, higher fever
What is wheezing? (Physically)
Bronchiospasms resulting from collapsing bronchioles
How do you measure ETT diameter for appropriate size?
It should be the diameter of the patients pinky
What is the formula for minute volume?
Tidal volume x respiratory rate = minute volume
What is the formula for how long an oxygen tank will last?
[(tank size - safe residual) x constant] / Lpm
What is the primary assessment tool for someone with difficulty breathing?
Listening to lung sounds
What is one reason the ETT is better than the cobra airway?
You can give meds down the ETT.
If you have gastric distention in an unresponsive patient, what should you do?
Use an ng tube
A c7 spinal injury would result in what?
The patient will hypoventilate because of not receiving information from the intercostal muscles
What causes stridor?
Upper airway narrowing
