Ch. 11 Airway Management Flashcards
Aerobic metabolism
Metabolism that can proceed only in the presence of oxygen; the main by-product is CO2.
Aerosol-generating procedure
Any airway manipulation that induces the production of aerosols that may present a risk for airborne transmission of pathogens, such as CPR.
Agonal gasps
Abnormal breathing patter 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 space) and respiratory rate
(TV - dead space) X RR = alveolar minute volume
Or:
Alveolar volume X RR = alveolar minute volume
Alveolar ventilation
The volume of air that reaches the alveoli. It is determined by subtracting the amount of dead space from the tidal volume.
TV - dead space = Alveolar volume
American Standard Safety System
A safety system for large oxygen cylinders, designed to prevent the accidental attatchment of a regulator to a cylinder containing the wrong type of gas.
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 canula is left in place during an intubation attempt, allowing for continuous oxygen delivery into the airways during all phases of the procedure.
Aspiration
In the context of the airway, introduction of vomitus or other foreign material into the lungs.
Ataxic respirations
Irregular, ineffective respirations that may or may not have an identifiable pattern.
Automatic transport ventilator (ATV)
A ventillation device attached to a control box that allows the variables of ventilation (i.e. rate, tidal volume, etc.) to be set. It frees the EMT to perform other tasks while the patient is being ventilated.
Bag-mask device
A device with a one-way valve and a face mask 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.
Bilateral
A body part or condition that appears on both sides of the midline.
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 amoungt of expired carbon dioxide.
Carina
Point at which the trachea bifurcates (divides) into left and right main stem bronchi.
Chemoreceptors
Monitor 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 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.
Denitrogenation
The process of replacing nitrogen in the lungs with oxygen to maintain a normal oxygen saturation level during advanced airway management.
Diffusion
Movement of gas from an area of higher concentration to an area of lower concentration.
Direct laryngoscopy
Visualization of the airway with a larygoscope.
Dyspnea
Shortness of breath. Difficulty breathing.
Endotracheal (ET) intubation
Insertion of an endotracheal tube directly through the larynx between the vocal chords 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 into 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 gasses 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 in between the vocal cords that is the narrowest prortion 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 mild airway obstruction. With good air exchange, the patient is still conscious and able to cough forcefully, although wheezing may be heard.
Gum elastic bougie
A flexible device that is inserted between the glottis under direct laryngoscopy; the endotracheal tube is threaded over the device, facilitating its entry into the trachea.
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 in the tissues.
Hypoxic trive
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 exghange of gasses between the blood cells and tissues.
Intrapulmonary shunting
Bypassing of oxygen-poor blood past nonfunctional aveoli to the left side fo the heart.
Jaw-thrust maneuver
Technique to open the airway by placing the fingers behind the angle of the jaw and brining 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 assisst in the expanding the chest; occurs when air movement is impaired.
Larynx
A complex structure formed by many interdependent ccartilaginous structures that all work together; where the upper airway ends and the lower airway begins; also called the voice box.
Mediastinum
Space within the chest that contains the heart, major blood vessels, vagus nerve, trachea, major bronchi, and esophagus; located between the two lungs.
Metabolism
The biochemical processes that result in the 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 amounts of 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 tidal volume and respiratory rate; also called minute ventilation.
TV X RR = MV
Nasal cannula
An oxygen-delivery device in which oxygen flows through two small, tubelike prongs that fit into the patient’s nostrils; delivers 24-44% supplemental oxygen, depending on the flow rate.
Nasopharyngeal (nasal) airway (NPA)
Airway adjunct inserted into the nostril of an unersponsive 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 (NRB mask)
A combination mask and reservoir bag system that is the preferred way to give oxygen in the prehospital setting; delivers up to 90% osygen and prevents inhaling the exhaled gasses (carbon dioxide).
Oropharyngeal (oral) airway (OPA)
Airway adjunct inserted into the mouth of an uresponsive patient to keep the tongue from blocking the upper airway to facilitate suctioning of 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 exessive oxygen consumption resulting in cellular and tissue damage.
Parietal pleura
The thin membrane that lines the chest cavity.
Partial pressure
The term used to descrive 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 compressions.
Patent
Open, clear of obstruction.
Phrenic nerves
The two nerves that innervate the diaphragm ; necessary for adequate breathing to occur.
Pin-indexing system
A system established for portable cylinders to ensure that a regulator is not connected to a cylinder containing the wrong type of gas.
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 poor air exchange, the patient often has a weak, ineffective cough, increased difficulty breathing, or possible cyanosis and may produce a high-pitched nois 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 oxymetry
An assessment tool that measures oxygen saturation of hemoglobin in the capillary beds.
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 exhanging oxygen and carbon dioxide.
Retractions
Movements in which the skin pulls in around the ribs durign inspriation.
Severe airway obstruction
Occurs when a foreign body completely obstructs the patient’s 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 a stethoscope.
Suction catheter
A hollow, cylindrical device used to remove fluid from the patient’s airway.
Surfactant
A liquid protein substance that coats the alveoli in the lungs, decreases the alveolar surface tension, and keeps the alveoli expanded; a low level in a premature infant contributes to respiatory distress syndrome.
Tension pneumothorax
An accumulation of air or gas in the pleural cavity that progressively increases pressure in the chest 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.
Tonsil tips
Large, semi-rigid suction tips redommended for suctioning of the pharynx.
Tracheostomy
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 exthange of air between the lungs and the environment; occurs spontaneously by the patient or with assistance from another person, such as an EMT.
Video laryngostopy
Visualization of the vocal cords, and thereby placement of the endotracheal tube, that is facilitated by the use of a video camera and monitor.
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 has 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 suggest an obstruction or harrowing of the lower airways; occurs in asthma and bronchiolitis.
