CHAP 9

Question 1

alveolar ventilation

Answer 1

the amount of air that reaches the alveoli

Question 2

artificial ventilation

Answer 2

forcing air or oxygen into the lungs when a patient has stopped breathing or has inadequate breathing. Also called positive pressure ventilation

Question 3

automatic transport ventilator (ATV)

Answer 3

a device that provides positive pressure ventilations. It includes setting designed to adjust ventilation rate and volume, is prattle, and easily carried on ambulance

Question 4

cellular respiration

Answer 4

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

Question 5

cricoid pressure

Answer 5

pressure applied to cricoid ring to minimize air entry into the esophagus during positive pressure ventilation. Also called Sellick maneuver

Question 6

cyanosis

Answer 6

a blue gray color resulting from lack of oxygen in the blood

Question 7

diffusion

Answer 7

a process by which molecules move from an area of high concentration to an area of low concentration

Question 8

flowmeter

Answer 8

a valve that indicates the flow of oxygen in liters per minute

Question 9

flow-restricted, oxygen-powered ventilation device (FROPVD)

Answer 9

a device that uses oxygen under pressure to deliver artificial ventilations. Its trigger is placed so that a rescuer can operate it while still using both hands to maintain a seal on the face mask. It is automatic flow restriction to prevent over delivery of oxygen to the patient

Question 10

humidifier

Answer 10

a device connected to the flowmeter to add moisture to the dry oxygen

Question 11

hypoxia

Answer 11

an insufficiency of oxygen in the body’s tissues

Question 12

pulmonary respiration

Answer 12

the exchange of oxygen and carbon dioxide between the alveoli and circulating blood in the pulmonary capillaries

Question 13

respiratory arrest

Answer 13

when breathing completely stops

Question 14

respiratory distress

Answer 14

increased work of breath, shortness of breath

Question 15

respiratory failure

Answer 15

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

Question 16

stoma

Answer 16

a permanent surgical opening in the neck through which the patient breathes

Question 17

tracheostomy mask

Answer 17

a device designed to go over the stoma to provide oxygen

Question 18

venturi mask

Answer 18

a face mask and reservoir bag devise that delivers specific concentrations of oxygen by mixing oxygen with inhaled air.

Question 19

Describe the signs of respiratory distress

Answer 19

rapid respiration, accessory muscle use, anxiety, pursed lip breathing, and the tripod position. In the case of respiratory distress the patient should have relative normal pulse oximeter and have a normal mental stays as increased respiratory efforts are meeting the metabolic needs of the body.

Question 20

Describe the signs of respiratory failure

Answer 20

All the respiratory distress signs plus signs that the body is no longer compensating for the respiratory challenge. These signs include altered mental status, dropping pulse oximeter, cyanosis, slowing/irregular restorations, and respiratory failure.

Question 21

Mouth-to-mask

Answer 21

connect oxygen to the inlet on the mask and run 15 liters per minute. Hold the mask firmly while maintaining the head tilt. Take a breathe and exhale into the mask port or one-way valve with just enough for chest rise. Remove mouth, and allow passive exhalation

Question 22

BVM

Answer 22

Position at head of patient. Suction if needed. Use the EC grip. With other hand squeeze bag every 5 seconds, enough for chest rise. Release pressure , let patient exhale

Question 23

FROPVD

Answer 23

Trigger the device every 5 second enough for chest rise.

Question 24

For BVM ventilation, describe recommended variations in techniques for one or two rescuers and for a patient with trauma suspected or trauma not suspected

Answer 24

For suspect trauma, the provider holding the mask must perform the jaw-thrust maneuver. For no suspect trauma, the head tilt chin lift

Question 25

Describe how positive pressure ventilation moves air differently from how the body normally moves air.

Answer 25

Normal breathing, the negative pressure pulls air into lung. Artificial Ventilation “push air in”

Question 26

Name patients problems that would benefit from administration of oxygen and explain how to decide what oxygen delivery device should be used for a particular patient.

Answer 26

Any condition that causes hypoxia will benefit from supplemental oxygen. These conditions include bronchospasm, acute pulmonary edema, and shock. Hypoxic patients most commonly benefit from high concentrations of oxygen delivered by NRB

Question 27

On arrival at the scene, you find an adult female patient who is semiconscious. Her respiratory rate is 7/min. She appears pale and slightly blue around her lips. What immediate actions are necessary? Is the patient in respiratory failure, and if so what signs and symptoms indicate this? Does this patients require artificial ventilations?

Answer 27

After assuring the scene is safe, open the patients airway and, if necessary, support it with an airway adjunct. Her altered mental status, slow respiration rate, and cyanosis all point to respiratory failure. The patient needs immediate respiratory assistance with a BVM and supp oxygen.

Question 28

On arrival at the scene, you find an adult male patient sitting bolt up in a chair. He looks at you as you come into the room, but is saying 2 words at a time. He seems to have prolonged expiratory phase; you hear wheezes, and respiratory rate is 36. What immediate actions are necessary? Is this patient in respiratory failure, and if so what sign and symptoms indicate this? Does this patient require artificial ventilation?

Answer 28

At a minimum, this patient needs supplemental oxygen. Further assessment will be necessary to identify respiratory failure, but his inability to speak and position certainly point to at least impending failure. If assessment indicate respiratory failure, then artificial ventilation is necessary.

Question 29

On arrival to a scene of a motor vehicle crash, you find an adult female patient pacing outside her vehicle. She appears to be breathing rapidly but acknowledges you as you approach. He color is normal and her reps rate is 48. What immediate actions are necessary? Is this patient in respiratory failure, and if so what are the signs and symptoms indicate this? Does the patient require artificial ventilation?

Answer 29

Although the patient might be anxious after the motor vehicle accident, a thorough assessment is needed to indicate the fast rate is not due to injury. Rapid respiratory rates can indicate inadequate breathing, but further assessment will be needed to identify respiratory failure.

Question 30

Describe the elements you would assess to determine if a patient is breathing adequately

Answer 30

To identify respiratory failure, both oxygenation and ventilation must be assessed. Mental status, skin color, and pulse oximeter all can be used to assess oxygenation. Listening to lung sounds, observing respiratory effort, and looking for accessory muscle use help assess ventilation. If no deficits in oxygenation or ventilation are noted during these assessments, the patient is breathing adequately. Any deficits with either element point to inadequate breathing and respiratory failure

Question 31

You are assessing a breathing patient. Describe what findings might indicate the need to initiate artificial ventilations despite the fact the patient continues to breathe.

Answer 31

A breathing patient may need artificial ventilation if his breathing is deemed to be inadequate. Signs include altered mental status, cyanosis, slowing or irregular resperations, and respiratory fatigue

Question 32

Describe how you would determine that you have delivered enough air (volume) when ventilating using a BVM.

Answer 32

When using BVM, watch for chest rise to assure adequate volume.