CHAP 9 Flashcards
alveolar ventilation
the amount of air that reaches the alveoli
artificial ventilation
forcing air or oxygen into the lungs when a patient has stopped breathing or has inadequate breathing. Also called positive pressure ventilation
automatic transport ventilator (ATV)
a device that provides positive pressure ventilations. It includes setting designed to adjust ventilation rate and volume, is prattle, and easily carried on ambulance
cellular respiration
the exchange of oxygen and carbon dioxide between cells circulating the blood
cricoid pressure
pressure applied to cricoid ring to minimize air entry into the esophagus during positive pressure ventilation. Also called Sellick maneuver
cyanosis
a blue gray color resulting from lack of oxygen in the blood
diffusion
a process by which molecules move from an area of high concentration to an area of low concentration
flowmeter
a valve that indicates the flow of oxygen in liters per minute
flow-restricted, oxygen-powered ventilation device (FROPVD)
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
humidifier
a device connected to the flowmeter to add moisture to the dry oxygen
hypoxia
an insufficiency of oxygen in the body’s tissues
pulmonary respiration
the exchange of oxygen and carbon dioxide between the alveoli and circulating blood in the pulmonary capillaries
respiratory arrest
when breathing completely stops
respiratory distress
increased work of breath, shortness of breath
respiratory failure
the reduction of breathing to a point where oxygen intake is not sufficient to support life
stoma
a permanent surgical opening in the neck through which the patient breathes
tracheostomy mask
a device designed to go over the stoma to provide oxygen
venturi mask
a face mask and reservoir bag devise that delivers specific concentrations of oxygen by mixing oxygen with inhaled air.
Describe the signs of respiratory distress
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.
Describe the signs of respiratory failure
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.
Mouth-to-mask
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
BVM
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
FROPVD
Trigger the device every 5 second enough for chest rise.
For BVM ventilation, describe recommended variations in techniques for one or two rescuers and for a patient with trauma suspected or trauma not suspected
For suspect trauma, the provider holding the mask must perform the jaw-thrust maneuver. For no suspect trauma, the head tilt chin lift
Describe how positive pressure ventilation moves air differently from how the body normally moves air.
Normal breathing, the negative pressure pulls air into lung. Artificial Ventilation “push air in”
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.
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
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?
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.
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?
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.
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?
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.
Describe the elements you would assess to determine if a patient is breathing adequately
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
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.
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
Describe how you would determine that you have delivered enough air (volume) when ventilating using a BVM.
When using BVM, watch for chest rise to assure adequate volume.
