ch 11 Flashcards
What is the upper airway composed of
nose mouth pharynx and larynx
What is the lower airway composed of
trachea bronchi bronchioles alveoli
What is the function of the epiglottis
to prevent food and liquid from entering the trachea during swallowing
What is the carina
point where trachea splits into right and left bronchi
What is the function of the alveoli
gas exchange between oxygen and carbon dioxide
What muscle is the main driver of breathing
the diaphragm
What is the difference between ventilation and respiration
ventilation = air movement and respiration = gas exchange
What is external respiration
gas exchange between alveoli and blood
What is internal respiration
gas exchange between blood and body cells
What is hypoxia
lack of oxygen to the tissues
What are signs of hypoxia
anxiety cyanosis altered mental status and increased respiratory rate
What is the most common cause of airway obstruction in an unresponsive patient
the tongue
What is suctioning used for
removing fluids (blood
How long should you suction an adult
no more than 15 seconds at a time
How long should you suction a child
no more than 10 seconds at a time
How long should you suction an infant
no more than 5 seconds at a time
What is the recovery position used for
maintaining a clear airway in an unconscious breathing patient with no trauma
When is the head tilt–chin lift used
when there is no suspected spinal injury
When is the jaw-thrust maneuver used
when trauma or spinal injury is suspected
What is an oropharyngeal airway (OPA)
a rigid device that keeps the tongue from blocking the airway
When is an OPA used
in unresponsive patients without a gag reflex
What is a nasopharyngeal airway (NPA)
a soft rubber tube inserted into the nose to keep the airway open
When is an NPA used
in patients with a gag reflex or semi-conscious
When is an NPA contraindicated
with suspected skull fractures or facial trauma
What are the normal oxygen saturation levels
95–100% SpO₂
When is supplemental oxygen indicated
if SpO₂ is <94% signs of hypoxia or difficulty breathing
What are the types of oxygen delivery devices
nasal cannula nonrebreather mask BVM pocket mask
What is the oxygen flow rate for a nasal cannula
1–6 L/min
What is the oxygen flow rate for a nonrebreather mask
10–15 L/min
What is the oxygen flow rate for a BVM (bag-valve mask)
15 L/min
What oxygen concentration does a nonrebreather provide
up to 90%
What oxygen concentration does a nasal cannula provide
24–44%
What is a BVM used for
patients who are not breathing or not breathing adequately
What are the signs of adequate breathing
equal chest rise normal rate and depth and no accessory muscle use
What are signs of inadequate breathing
shallow irregular slow or fast respirations; cyanosis; poor chest rise
What is gastric distention
air entering the stomach during artificial ventilation
How can you prevent gastric distention
ventilate slowly and with proper volume
What should you always do after inserting an airway adjunct
reassess airway and breathing
What are signs of airway obstruction
stridor gurgling snoring absent breath sounds and cyanosis
How do you confirm proper ventilation with a BVM
visible chest rise and fall
What does a pulse oximeter measure
percentage of oxygen bound to hemoglobin
What is the purpose of humidified oxygen
to prevent drying of the airways during long-term use
What should you do if a patient becomes unresponsive during oxygen administration
reassess airway breathing and circulation immediately
What is the most important step in treating any life threat
opening and maintaining the airway
What is the sniffing position
head position that aligns airway axes in pediatric patients for optimal airway opening
How do you measure an OPA
from the corner of the mouth to the earlobe or angle of the jaw
How do you measure an NPA
from the tip of the nose to the earlobe
How do you insert an OPA in an adult
insert upside down then rotate 180°
How do you insert an OPA in a child or infant
use a tongue depressor and insert right side up (no rotation)
When do you suction a patient
before ventilating if there’s vomit blood or secretions in the airway
What do you do if the patient gags on an OPA
remove it and consider using an NPA instead
What is a sign of a poorly sized or mispositioned airway adjunct
it does not stay in place or causes gagging
Why is suctioning limited to 15 seconds in adults
to prevent hypoxia during the process
What do you do if vomit is continuous
suction for 15 seconds ventilate for 2 minutes then suction again
How often should you reassess a patient’s airway
continuously (especially after interventions)
What is an indication for positive pressure ventilation (PPV)
inadequate or absent spontaneous breathing
What is one danger of over-ventilation
gastric inflation which can cause vomiting or aspiration
What is one danger of under-ventilation
hypoxia and worsening of condition
What is the PSI of a full oxygen cylinder
2000 psi
When should you change an oxygen tank
when it drops below 200 psi
What is a pressure regulator
device that reduces tank pressure to a usable level (30–70 psi)
What is a flowmeter
controls how fast oxygen is delivered (in liters per minute)
What are the dangers of oxygen equipment
they can ignite under pressure and are highly flammable
When do you use a BVM with a reservoir
in apneic or severely hypoventilating patients
What is a nonrebreather mask best used for
patients with adequate breathing but signs of hypoxia
When should a patient not receive oxygen via nasal cannula
if they have severe respiratory distress or need high concentrations of O₂
What can pulse oximetry be affected by
cold extremities poor perfusion CO poisoning nail polish and bright lights
What does stridor indicate
upper airway obstruction (typically partial and high-pitched)
What does gurgling indicate
fluid in the upper airway
What does snoring indicate
tongue blocking the airway
What is agonal breathing
irregular gasps not adequate for life — not real breathing
Why must airway assessment be continuous
the airway can become obstructed at any time
What is the first step in managing respiratory failure
open the airway and provide assisted ventilations
What is a sign that the patient is tiring from breathing
decreased respiratory rate and shallow effort
What is a sign that a pediatric airway is becoming compromised
nasal flaring
What should you do before inserting any airway adjunct
open the airway with a manual maneuver and check for obstructions
What does cyanosis around the lips or nail beds indicate
poor oxygenation and possible respiratory failure
What are retractions
inward movement of the chest wall during inspiration due to increased work of breathing
What are accessory muscles
neck intercostals and abdominal muscles used when breathing is labored
What should be done if a patient vomits during ventilation
immediately roll to side and suction airway
What is the purpose of a BVM with a reservoir
to deliver nearly 100% oxygen when connected to O₂ at 15 L/min
What should you do if chest rise isn’t seen with BVM ventilation
reposition the head and mask and try again
How often should you ventilate an apneic adult
once every 5–6 seconds
How often should you ventilate an apneic child or infant
once every 3–5 seconds
What happens if you hyperventilate a patient
reduces CO₂ too much and decreases blood flow to the brain
Why is ventilation more difficult in patients with facial trauma
bleeding and swelling can obstruct the airway
Why should you be careful with suctioning in infants and children
stimulation may trigger bradycardia via vagus nerve
What is the tidal volume
the amount of air moved in and out of the lungs in one breath
What is minute volume
respiratory rate x tidal volume
What happens to minute volume if tidal volume decreases
it drops (resulting in hypoventilation)
How can you assess tidal volume in the field
observe chest rise and listen for air movement
What is the difference between oxygenation and ventilation
oxygenation = O₂ delivery and ventilation = air movement
Why is ventilation ineffective in cardiac arrest without compressions
no circulation to move oxygen to tissues
Why are manually triggered devices not preferred
high risk of gastric inflation and barotrauma
What should you do if a patient has dentures
leave them in place unless they obstruct the airway
What is one sign of a completely obstructed airway
inability to speak cough or breathe
What are the two types of airway obstruction
anatomical (tongue
How can you tell the difference between a mild and severe airway obstruction
severe = no sound or cough and mild = noisy cough or wheeze
What should you do for a responsive adult with a severe obstruction
abdominal thrusts (Heimlich maneuver)
What should you do for an unresponsive choking patient
start chest compressions and check airway for obstruction
How does positive pressure ventilation differ from normal breathing
normal is negative pressure PPV pushes air into lungs
What are signs of effective PPV
improved color chest rise normal pulse rate and improved mental status
What does a BVM without a reservoir deliver
around 50% oxygen
What can cause a falsely high SpO₂ reading
carbon monoxide poisoning
How can you tell if a patient is tiring from respiratory distress
decreasing respiratory rate and effort and an altered LOC
What are signs of upper airway obstruction
stridor hoarseness and gurgling
What are signs of lower airway obstruction
wheezing and diminished breath sounds
What should you do if a child has a partial airway obstruction but is coughing forcefully
encourage coughing and monitor closely
Why is rapid transport essential in patients with compromised airway
airway failure can happen quickly and may become unmanageable in the field
