CH 6: Airway Management & Resp. Emergencies

Question 1

What are 5 Airway Adjuncts used to secure an airway?

Answer 1

1) Head tilt - chin lift
2) Jaw Thrust
3) Manual Suction
4) Oropharyngeal Airway
5) Nasopharyngeal Airway

Question 2

Describe an Oropharyngeal airway

Answer 2

A curved device usually made of plastic that rests in the oropharynx and against a patients lips that greatly reduces the chances of the tongue obstructing the airway, allowing for hands-free delivery of emergency O2

Question 3

Describe an Nasopharyngeal airway

Answer 3

A soft-plastic device used to secure an airway path through the patients nasopharynx. To be used if an OPA is not advised, and can be used on a conscious patient.

Question 4

What are the S/S of a skull fracture/head trauma?

(for determining if an NPA is viable)

Answer 4

1) Periorbital Ecchymosis
2) Periauricular Ecchymosis
3) Nose bleeds
4) Foreign fluids leaking from any facial orifice
5) Pupils that are unequally reacting to light

Question 5

What is Manual Suction and when is it best implemented?

Answer 5

A manual suction tool used to remove fluid buildup in the back of a patients airway when rolling them is not an option.

Usually only found on ambulances, they are either battery or oxygen powered and measured the same as an OPA

Question 6

What is the purpose of a Pulse Oximeter?

Answer 6

A device used to measure the oxygen saturation of the blood. Useful on alert patients, patients with little physical trauma and only to be used to support the assessment, as there are a lot of reasons why a Pulse Oximeter can give faulty readings.

Question 7

What is Hypoxia and what are the signs and symptoms?

Answer 7

Hypoxia is a condition in which the body’s cells are receiving insufficient oxygen.

This can result in the following S/S:
- Increased respiration rate
- Increased HR
- Restlessness
- Cyanosis
- Chest pain
- Abrupt changes in responsiveness

Question 8

What things should be present on/in an emergency oxygen case?

Answer 8

• O2 cylinder itself
• Pressure regulator
• Key
• Delivery device
• Label indicating that the tank does in fact carry oxygen

*Check the regulator for tank level: 200 PSI = empty / 2000 PSI = full

Question 9

What percentages of oxygen are being delivered to a patient with associated delivery device?

Answer 9

Rescue breathing w/ resuscitation mask + no supplemental o2 = 16% oxygen
Rescue breathing w/ resuscitation mask + supplemental O2 = 50% oxygen
Bag-Valve-Mask w/ no supplemental O2 = 21%
Bag-Valve-Mask + supplemental O2 + O2 reservoir = 100%

Question 10

What are 6 situations when high-flow emergency oxygen is advised?

Answer 10

1) Asphyxiation (suffocation)
2) Dyspnea (Shortness of breath)
3) Hypoxia (Lack of O2)
4) SpO2 reading less than 95%
5) Carbon monoxide exposure
6) Decompression sickness

Question 11

When working with O2, ALWAYS…

Answer 11

1) Use gauges and equipment designed for use with O2
2) Maintain hardware in good condition
3) Use medical grade O2
4) Store in a cool ventilated room
5) Have tanks tested every 5 years (or manufacturers specs)

Question 12

When working with O2, NEVER…

Answer 12

1) Drop the tank or let it fall
2) Leave it free standing
3) Allow smoking in proximity
4) Operate around open flames or sparks
5) Use adhesive tape on tank
6) Drag or roll tank
7) Leave O2 flowing near an active AED

Question 13

What is the difference between Respiratory Arrest and Respiratory Distress?

Answer 13

Respiratory Arrest occurs when patients ceases breathing altogether.

Respiratory Distress is when Breaths per minute drop below 10 or higher than 30

Question 14

What are the average respiration rates and what is the normal quality of breathing?

Answer 14

Adult: 12-20 breaths/min
Child: 16-24 breaths/min
Baby/Neonate: 30-40 breaths/min

Regular, quiet & effortless

Question 15

What occurs at 4 minutes without breathing? (And therefore no oxygen?)

Answer 15

Clinical death occurs somewhere between 0-4 mins when the heart stops pumping blood.
Biological death occurs somewhere beyond 4 mins when brain and organ function cease.

Question 16

Important definitions regarding types of breathing (5)

Answer 16

Hypoxia: Insufficient amounts of O2 are reaching the cells
Anoxia: Total lack of O2 (usually related to death)
Dyspnea: Difficulty or laboured breathing
Apnea: Cessation of breathing
Eupnea: Normal respirations

Question 17

What are 3 conditions in which O2 is not available for respirations?

Answer 17

Environmental: High altitudes reduce the overall amount O2 present.
Displacement: Other gases (CO) take up the space that O2 would normally occupy.
Consumption: Confined spaces mean there is physically less space for O2 to exist and therefore will be used quicker.

Question 18

Characteristics of a partial vs completely blocked airway

Answer 18

Partial: Coughing, speaking and wheezing are possible. Patient will be highly anxious
Complete: No sound or noise will be able to escape the airway.

Question 19

Characteristics of Emphysema

Answer 19

The alveoli loose elasticity and become distended with trapped air, reducing the lungs ability to exchange gases effectively. Usually caused by smoking and develops over time.

S/S: Shortness of breath, difficulty exhaling, coughing, finger clubbing, fever, restlessness, confusion, weakness.

Question 20

Characteristics of chronic Bronchitis

Answer 20

General term for inflammation of the bronchial tubes, which results in excessive mucous secretions in the bronchial tubes creating a constricted air passageway.

Can be acute or chronic

S/S: Shortness of breath, coughing with sputum and cyanosis.

Question 21

Characteristics of Bronchospasms

Answer 21

The terminal bronchioles become swollen and fluid-filled and the smooth muscle surrounding them contracts, further constricting the airway.

S/S: Shortness of breath and wheezing

Question 22

What initiates the drive to breathe in healthy people V people with COPD?

Answer 22

Healthy people: the levels of CO2 in the blood

COPD Patients: The level of O2 in the blood. CO2 is constantly high because of poor respiratory conditions so when O2 gets low, that increases the respiratory rate

Question 23

What is ARDS?

Answer 23

Acute Respiratory Distress Syndrome.
Often occurs in patients with other serious lung illnesses or have suffered serious chest trauma.

Characterized by increase in fluid between alveolar membrane and surrounding pulmonary capillaries, leading to less O2 absorbed by RBC’s.

Question 24

What is Asthma, what causes it and what can treat it?

Answer 24

Inflammation of the air passages (namely bronchi and subsequent passages) reducing diameter in which air can flow in and out of lungs.

Characterized by wheezing on exhalation, recurring dyspnea, and chest tightness.
Can be triggered by stress, exercise, allergens and weather.

Can be treated with corticosteroids for prevention and broncho-dilators for immediate control.

Question 25

What is Pneumonia?

Answer 25

A blanket term used to describe a group of illnesses characterized by lung infection and fluid filled alveoli that results in hypoxia. Caused by airborne irritants and bacteria or viruses.

Question 26

What is Acute Pulmonary Edema?

Answer 26

An build-up of fluid in the lungs. Likely a result of left sided heart failure causing blood to back up into the lungs resulting in excess fluid leaking into the alveoli and lowering O2 saturation in blood.

Question 27

What is a Pulmonary Embolism?

Answer 27

An embolus that has formed in another part of the body has broken free and travelled to the Pulmonary arteries where it has lodged and now partially or fully blocked a pulmonary artery. Usually forms in larger veins in the lower extremities.

Question 28

What is JVD?

Answer 28

Jugular Vein Distention is protrusion of the jugular vein in the neck as a result of backed-up fluid in the lungs.

Question 29

What are 4 general treatment options for respiratory emergencies?

Answer 29

1) Administer O2
2) Maintain normal body temperature (to decrease inflammation of bronchioles)
3) Rest in comfortable position
4) Reduce environmental heat/humidity (same as 2)