Airways Study Guide Flashcards
Describe the pathway of oxygen as it enters the body and gets to the alveoli
Oxygen reaches body tissues and cells through breathing and circulation.
During inhalation, oxygen moves from the atmosphere into the lungs, then crosses the alveolar membrane onto hemoglobin by diffusion.
Then the red blood cells carry the hemoglobin and oxygen through the body and deliver it to the capillaries to oxygenate the body’s cells.
Define the process of diffusion and where it occurs in the lungs
Diffusion is the process where molecules move from a higher level of concentration to an area of lower concentration.
This occurs in the lungs between the gas in the alveoli and the blood in the capillaries in the lungs.
List the steps in caring for a patient who is choking,
including responsive
And unresponsive patients
A responsive patient that is choking may have a mild or severe obstruction. If they have a mild obstruction with good air exchange, you may hear wheezing, and are able to cough forcefully, then encourage them to keep coughing and continue to monitor.
If they have a mild obstruction with poor air exchange, you may hear stridor and that sounds high pitched, you would treat this as if it were a severe airway obstruction.
A severe airway obstruction in a responsive patient is treated with abdominal thrusts. In a patient that is unresponsive, not breathing, and without a pulse, begin CPR. If there is resistance during the ventilations, then begin a tongue jaw lift after the 30 compressions. Pull the mouth/jaw open and look inside, if you can see the object remove it with your index finger or with suction.
If you still can’t remove the object, immediately transport and continue to reattempt. If the patient is conscious with a mild obstruction, and good air exchange, provide them with oxygen as you transport them.
Describe the indications for suctioning and describe the technique for doing so
Gurgling is a sign that they need suctioning, also if there is resistance during ventilations
Contrast the rigid suction and soft suction catheter including when to use each
The soft suction catheter (Sometimes called French or whistle tip, non-rigid) are used for patients with a stoma, suctioning the nose, and liquid secretions in the back of the mouth and clenched teeth. when a rigid suction catheter can’t be used. Never more than 15 secs for an adult, 5 for a child
List the indications for the head tilt chin-lift and jaw thrust maneuvers
Use Head tilt chin lift on patients NOT suspected of having spinal trauma. Pull up chin while holding head down.
Use Jaw thrust on patients with suspected spinal trauma
Describe the technique for applying an oropharyngeal and nasopharyngeal airway
B
List the steps in the primary assessment including the pertinent findings
B
Describe which muscles are working during inhalation and exhalation
When a person inhales, the diaphragm and intercostal Contract.
Exhalation. Doesn’t usually need muscular help. The diaphragm and intercostal muscles relax.
Describe the role of the phrenic nerve
The phrenic nerve, found in the thorax innervates the diaphragm muscle , allowing it to contract. Necessary for adequate breathing to occur
List the upper and lower airway sounds and which condition would likely be heard with each
B
List the proper oxygen flow rate in liters per minute for the nasal cannula, non-rebreather mask, and bag-valve-mask.
Nasal cannula - 1-6 liters
Non-rebreather - 10-15 liters
BVM - Bag valve Mask - 15 liters
Contrast the signs and symptoms and breathing rates of a patient suffering from respiratory distress and respiratory failure (remember this is also what differentiates who gets assisted ventilations or oxygen via non-rebreather mask
Respiratory Distress
Assisted Ventilation
Continuous Positive Airway Pressure (CPAP)
Respiratory Failure
List the steps for ventilating a patient who has a stoma
If there is a tube, ventilating with a BVM can be done by attaching the BVM directly to the tracheostomy tube with the attached adapter (remove the mask from the BVM). Your patient should also get high flow 02 at 15 LPM by attaching the oxygen tubing directly to the BVM.
If the patient does not have a tube, use an infant or child mask to create an airtight seal around the stoma. Seal the mouth and nose with one hand (if you are alone) and ventilate the patient through the stoma with the BVM in the other hand
- Look for adequate chest rise then release the seal on the nose and mouth allowing more air to escape through the upper airway during exhalation.
- If patient with stoma or tracheostomy does not have adequate chest rise while ventilating, try suctioning the stoma and mouth with a soft tipped catheter before you attempt to deliver breathes through the patient’s mouth or nose. If you have to ventilate through the mouth or nose of a tracheostomy patient you may find it easier if the actual stoma in the trachea is sealed during the delivery of ventilations. Remember that unlike other patients, patients who are being ventilated via a stoma will not benefit from the head tilt chin lift maneuver nor the jaw thrust maneuver in an attempt to open the airway. The tracheostomy opening is far below the pharynx and potential occlusion by the tongue.
Define the following respiratory-related terms: tidal volume, minute volume, compliance, seesaw respirations, dyspneic, and apneic
Tidal volume: the amount of air (in milliliters) that is moved in or out of the lungs during one relaxed breath; about 500 mL for an adult
Minute volume: another measure used to assess the amount of air that moves in and out of the lungs in 1 minute -> Respiratory rate x Tidal volume= minute volume
Compliance: the ability of the alveoli to expand when air is drawn in during inhalation
Seesaw respirations: chest and abdominal muscles alternately contract to look like a seesaw
Dyspneic: shortness of breath
Apneic: there is no movement of the muscles in inhalation so there is no breathing
