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Emergency care 13th edition > Chap 10 > Flashcards

Chap 10 Flashcards

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1
Q

Negative effects of Artificial ventilation

A
  • Decrease cardiac output/ dropping blood pressure
    • The heart uses the negative pressure the assist in the filling of the chambers with blood. With positive pressure it goes away and the heart can compensate but at risk of blood pressure drop. You can minimize this by using just enough volume to raise the chest
  • Gastric distention
  • Hyperventilation
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2
Q

Mechanical failures of the Cardiopulmonary system

A

Mechanics of breathing disrupted

- Stabbed in chest- Tension pneumothorax 
- Loss of nervous control of respiration- Myasthenia gravis and multiple sclerosis 
- Painful chest wall injuries- Pain or damage that limits chest wall movement
- Airway problems such as bronchoconstriction- Asthma or COPD

Gas exchange interrupted

- Low oxygen levels in the outside air
- Diffusion problems- COPD

Circulation issues

- Not enough blood- Blood loss
- Hemoglobin problems- Anemia
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3
Q

How is intubation checked if tube is correctly placed?

A
  • Auscultation of both lungs and epigastrium expanding

- Using a capnometry or an end-tidal CO2 detector device

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4
Q

Noninvasive positive pressure ventilation (NPPV)

A

Assists the ventilations of a breathing patient by assuring that each breath the patient takes maintains adequate pressure within the respiratory tract, improving alveolar ventilation and gas exchange

  • CPAP (continuous positive airway pressure)
  • BiPAP (biphasic continuous positive pressure)
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5
Q

Nonrebreather mask stats

A

12-15 liters per minute

80-90%

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6
Q

Two types of advanced airway devices

A
  • Devices that require direct visualization of the glottic opening (endotracheal intubation)
    • Laryngoscope is used to visualize the airway
    • Blind insertions need head in neutral position
  • Devices that are inserted blindly
    • King LT airway, Combitube, and laryngeal mask airway (LMA)
    • Head in sniffing position
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7
Q

Artificial ventilation(positive pressure ventilation)

A

Forcing air or oxygen into the lungs when a patient has stopped breathing or has inadequate breathing

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8
Q

Major causes of hypoxia

A
  • Trapped in a fire
    • Air contains smoke and reduced amounts of oxygen
  • Has emphysema
    • Decreases efficiency of the transfer of oxygen
  • Overdose and depressing effect on respiratory system
    • Not breathing enough to support oxygen needs
  • Heart attack
    • Oxygenated blood can’t be delivered to body due to damaged heart cannot pump the blood
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9
Q

if expirations are prolonged

A

indicating possible lower airway obstruction

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10
Q

Multiple sclerosis

A

Demyelinating disease in which the insulating covers of the nerve cells in the brain and spinal cord are damaged. This damage disrupts the ability of parts of the nervous system to communicate

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11
Q

Pressure regulators bring the cylinder pressure down to what PSI range?

A

30-70 PSI

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12
Q

Alveolar ventilation

A

how much air actually make it to the alveoli

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13
Q

E cylinder contains

A

625 liters

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14
Q

Signs of inadequate breathing

A
  • Chest movements are absent, minimal, or uneven
  • Abdominal breathing
  • No air felt or heard at the nose or mouth
  • Breath sounds are diminished or absent
  • Noises
  • Rate of breathing is too rapid or slow
  • Breathing is very shallow, deep or appears labored
  • Cyanosis
  • Inspirations/ expirations are prolonged
  • Unable to speak or cannot speak full sentences
  • retractions
  • Nasal flaring especially in infants and children
  • Low oxygen saturation (<95%)
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15
Q

Average ventilation a sec

  • Adults
  • Children
A

Adults- 5 secs

Children- 3 secs

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16
Q

If patient is breathing to slow and requires ventilation?

if rate is very slow?

A
  1. Bag patient on every inhale

2. Add ventilations in between the patients own to obtain a rate of 10-12 adult (20 for children and infants)

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17
Q

Automatic transport ventilator

A

device that provides positive pressure ventilation

- adjusts for ventilation rate and volume

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18
Q

humidifier

A

a device connected to the flow meter to add moisture to the dry oxygen. Can dry out mucous membrane

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19
Q

Inhalation is a _____process

A

Active

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20
Q

Gastric distention

A
  • Filling of the stomach with air through the esophagus during positive pressure ventilation
  • Side effects-vomiting, restriction of the movement of the diaphragm
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21
Q

What do you do with artificial ventilation if respirations are slow or fast?

A

Bag on patients inhales and then slowly adjust to normal breathing rates

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22
Q

Two diseases of bronchoconstriction?

A

Chronic obstructive pulmonary disease (COPD)

Asthma

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23
Q

Color of oxygen cylinders

A

Green or White

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24
Q

M cylinder contains

A

3000 liters

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25
Q

Decrease Cardiac output/ dropping blood pressure from positive pressure ventilation

A
  • Normally the heart uses the negative pressure of ventilation to assist the filling of its chambers with blood. When positive pressure is used to ventilate, we eliminate that negative pressure and filling assistance
  • Most times the heart can compensate but at risk of drop in blood pressure
26
Q

Hyperoxygenation

A

Ventilating the patient normal to slightly more not exceeding 20 breaths per minute for no more than 2-3 minutes. this makes sure patient is oxygenated for intubation

27
Q

Emphysema

A

Lung disease that decreases the efficiency of the transfer of oxygen between the atmosphere and the body

28
Q

G cylinder contains

A

5300 liters

29
Q

diffusion of oxygen and carbon dioxide between the alveoli and circulating blood

A

Pulmonary respiration

30
Q

What’s oxygen cylinders made of and filled to?

A

a seamless steel, aluminum, stainless steel, lightweight alloy and is filled to equal 2000-2200 psi

31
Q

Adequate breathing

 - Adult
 - Child
 - Infant
A
  • Adult-12-20
  • Child-15-30
  • Infant-25-50
32
Q

Cyanosis

A

blue or grey color resulting from lack of oxygen in the body

33
Q

Low pressure flow meters

A
  • Pressure compensated flowmeter
    • Gravity dependent ball float
  • Constant flow selector valve
    • Pressure selector switch
34
Q

Myasthenia gravis

A

long-term neuromuscular disease that leads to varying degrees of skeletal muscle weakness

35
Q

How long should intubation take no longer than?

A

30 secs

36
Q

Partial rebreather mask

A

9-12 liters per minute
40-60%
Usually not used by EMTs but for home use

37
Q

Types of artificial ventilation

A
  • Mouth to mask
  • Two-rescuer bag valve mask (BVM)
  • Flow-restricted, oxygen-powered ventilation device (FROPVD)
  • One-rescuer bag valve mask
38
Q

D cylinder contains

A

350 liters

39
Q

Nasal canula

A

1-6 liters per minute

24-44%

40
Q

Ventilation rates
Adult
Child
Infant

A

Adult -10-12
Child - 20
Infant- 20 minimum

41
Q

If inspirations are prolonged

A

indicating possible upper airway obstruction

42
Q

Don’t let O2 cylinders get blow what PSI

A

200 PSI

43
Q

What’s the system call when circulatory and the respiratory systems work together?

A

Cardiopulmonary system

44
Q

What happens to hemoglobin’s in high pH blood?

A

difficulty holding oxygen

45
Q

H cylinder contains

A

6900 liters

46
Q

FROPVD

A

Flow-restricted, oxygen-powered ventilation device

 - Manually triggered ventilation device
 - Peak flow rate of 100% up to 40 liters per minute
 - pressure relief valve opens at 60cm pressure
 - audible alarm when relief valve is activated
47
Q

Bag Valve Mask (BVM) stats

A
  • 15L per minute
  • BVM without reservoir delivers 50%
  • BVM with reservoir delivers 100%
  • Bag holds 1,000-1,600 mL
48
Q

Respiratory failure (inadequate breathing)

A

the reduction of breathing to the point where oxygen intake is not sufficient to support life

49
Q

Venturi mask

A

up to 15 liters per minute

24-60%

50
Q

What 2 lubrications to use on a NPA

A

Water based and non petroleum

51
Q

Respiratory arrest

A

when breathing completely stops

52
Q

diffusion of oxygen and carbon dioxide between the cells and circulating blood

A

cellular respiration

53
Q

Tracheostomy mask

A
  • 8-10 liters per minute
  • adjustable %
  • Used to ventilate through a stoma or tracheostomy
  • Clear mucus or secretions
  • Use pediatric mask to ventilate stoma
  • If unable to ventilate through stoma, seal off stoma and ventilate through mouth and nose
  • Leave head and neck in neutral position if ventilating through stoma
54
Q

Pocket face mask stats

A
  • 16% oxygen without O2 supplementation

- 50% with high concentration oxygen

55
Q

Hyperventilation

A
  • Caused by ventilating to fast
  • To much carbon dioxide blow off
  • causes vasoconstriction in the body and can limit blood flow to the brain
56
Q

Other dangers of oxygen administration

A
  • Oxygen toxicity or air sac collapse
    • Body reacts to “overload” of oxygen and reduces lung activity and collapses air sac
  • Infant eye damage
    • Premature babies can develop scar tissue on the retina of the eye with to much oxygen
  • Respiratory depression or respiratory arrest
    • People with COPD can have their “drive to breath” wiped out from to much oxygen
57
Q

BURP

A

Bringing Up and to the Right Position

58
Q

Exhalation is a _______process

A

Passive

59
Q

Respiratory distress

A

increased work of breathing; a sensation of shortness of breath

60
Q

Three major issues to consider when administering oxygen.

A
  • Oxygen is a drug
  • Oxygen can cause harm
  • Oxygen should be administered based on your overall evaluation of the patients presentation and possible underlying conditions

Emergency care 13th edition (32 decks)

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