Chapter 10 Respiration and Artificial Ventilation Flashcards

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1
Q

Alveolar Ventilation

A

the amount of air that reaches the alveoli

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2
Q

Tidal Volume

A

the amount of air moved in one breath

- Normal tidal volume is typically 5-7mL per Kg of body weight

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3
Q

Minute Volume

A

The amount of air moved into and out of the lungs “Per Minute”

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4
Q

Dead Air Space

A

roughly a little less then a 1/3 of our tidal volume doesn’t reach alveoli. that remainder is found in the Trachea, Bronchioles, and other parts of airway is known as

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5
Q

Cellular respiration

A

Gas exchange of O2 and CO2 at the cellular level with circulating blood

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6
Q

Dysfunctions of CardioPulmonary System - pathophysiology

A

Mechanics Disrupted

  • Patient stabbed in chest results in outside air filling pleural space resulting in harder time for lungs to create negative pressure to breath
  • Medulla Oblongata damaged by trauma or disease
    • some diseases are myasthenia gravis and multiple sclerosis
  • Airway problems like Bronchoconstriction caused by COPD or asthma

Gas Exchange interrupted

  • low O2 from environment
  • Diffusion problems from disease like
    • Heart failure and COPD (Chronic Obstructive Pulmonary Disease)

Circulation Issues

  • Not enough Blood - Severe Bleeding
  • Hemoglobin Problems
    • diseases like Anemia cause low amounts of hemoglobins in blood or when body pH becomes to Acidotic may make hemoglobins have a difficult time holding oxygen
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7
Q

Hypoxia

A

Low levels of Oxygen

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8
Q

Chemoreceptors

A

Receptors that detect increasing levels of CO2 in body as well as low O2
- stimulate respiratory system to breathe more rapidly

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9
Q

Hypercapnia

A

High levels of CO2

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10
Q

Respiratory Distress

A

increased level of breathing, HR and position change may be enough to meet challenge
- a sensation of shortness of breath S.O.B

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11
Q

Respiratory Failure

A

stage 2

  • Hypoxic
  • Stages of Hypercapnia
  • muscles for respiration start to tire
  • inadequate breathing
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12
Q

Respiratory Arrest

A

Stoppage of breathing

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13
Q

Respiratory Distress Signs and intervention

Adequate Breathing

A

Increased work of breathing; a sensation of shortness of breath

  • O2 by nonrebreather mask (12-15ml of O2) or nasal cannula (2-6ml of O2)
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14
Q

Respiratory Failure Signs and Intervention

Inadequate Breathing

A

Signs
- patient has some breathing but not enough to live
- rate and/or depth outside of normal limits
- shallow ventilations
- diminished or absent breath sounds
- noises such as stridor, crowing, snoring, gasping, gurgling
- blue (cyanotic) or gray skin color
- decreased minute volume
- O2 saturation less then 95%
Intervention
- assisted ventilation with BVM maybe with O2 hooked up to it

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15
Q

Patient is not Breathing Signs and Intervention

Respiratory Arrest

A

When breathing completely stops

  • Oxygen saturation extremely low or not obtainable
    Intervention
  • Artificial Ventilation
  • BVM - 10-12/min for adult, 20/min for child,
    20+/min for infant

*Note: Don’t use O2 powered devices on infants or children

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16
Q

Cyanosis

A

A blue or gray color resulting from lack of oxygen in the body

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17
Q

Several major causes of Hypoxia

A
  • O2 deprived environment
  • Patient with emphysema
  • patient ODs on Drugs resulting in low RR
  • Heart attack disturbing circulatory to lungs
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18
Q

Negative sides effects of positive pressure ventilation

A
  • Decreasing cardiac output/ dropping BP, positive pressure not letting heart fill back up
  • gastric Distention - filling stomach with air through esophagus
  • hyper ventilation - Too much carbon dioxide to be blown off. Causes vasoconstriction narrowing of the blood vessels, can limit blood flow to the brain.
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19
Q

Hyperventilation

A

Causes “Vasoconstriction” (narrowing of blood vessels) limiting blood flow to the brain

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20
Q

Techniques of artificial ventilation

A
  • chest rise and fall
  • rate of ventilation 10-12/ min for adults
    • 20/min for children
    • 20+ / min for infant
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21
Q

CPAP

A

Continuous positive airway pressure

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22
Q

NPPV

- can only be used by what kind of patient?

A

Noninvasive positive pressure ventilation

- only by awake patients that are breathing on their own! Goes for CPAP and BiPAP

23
Q

BiPAP

A

Biphasic continuous positive airway pressure

24
Q

BVM

A

Bag Valve Mask

  • at least 15L/min for O2
  • bag will hold 1000-1600mL of air
  • hooked to O2 without reservoir is 50%
  • with reservoir provides 100%O2
25
Q

Stoma

A

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

26
Q

FROPVD

A

Flow restricted oxygen powered ventilation device

Peak flow 100%O2 up to 40 L/min
Has trigger
Inspiration pressure relief valve opens at 60cm of water pressure

*only used on adults

27
Q

Oxygen cylinders

A

Green cylinders
Never allowed to be emptied all the way

D cylinder contains 350 L of O2
E cylinder contains 625 L of O2
M cylinder contains 3000 L of O2

Fixed systems on ambulances
G cylinder contains 5300 L of O2
H cylinder contains 6900 L of O2

All filled with 2000-2200 psi

28
Q

Nonrebreather mask

A

A face mask and reservoir bag device that delivers high concentrations of oxygen. Patients exhaled air escapes through a valve and is not rebreathed

12-15 L/min

Must fill reservoir before mask is placed on patients face
Provides 80 to 100% concentrations of O2

29
Q

Nasal Cannula

A

Provides low concentrations of O2
24-44%O2
Set anywhere from 2-6L/min

30
Q

Venturi mask

A

A face mask and reservoir bag device that delivers specific concentrations of oxygen by mixing oxygen with inhaled air

  • used on patients with COPD
  • up to 15 L/min
  • 24-60% O2
31
Q

Tracheostomy mask

A

A device designed to be placed over a stoma or tracheostomy tube to provide supplemental oxygen

Set at 8-10 L/min

32
Q

Special Considerations in airway management

A
  • Facial injuries - frequent suctioning or endotracheal tube may be necessary
  • obstructions - manual techniques like abdominal thrust, chest thrust or finger sweeps.
  • Dental appliances - Dentures leave in place if possible but be prepared to remove if endangering airway
33
Q

Alveolar respiration

A

Gas exchange of O2 and CO2 in the alveoli and pulmonary capillaries or

34
Q

What happens when Body PH become acidotic

A

may make hemoglobins have a difficult time holding oxygen

35
Q

How much is 1 kg in lbs?

A

Equals 2.2 lbs

36
Q

Inspirations (inhalation’s) that are prolonged?

A

Indicate a possible upper airway obstruction

37
Q

Expirations (exhalations) that are prolonged?

A

Indicate possible lower airway obstruction

38
Q

Emphysema

A

Lung disease that decreases the efficiency of the transfer of O2 between the atmosphere and the body leading to hypoxia

39
Q

Artificial ventilation

A

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

40
Q

Pocket mask O2 delivery

A

Approx 50% O2 from mask when 100% O2 connected

41
Q

Oxygen cylinders are made up of?

A

Made up of either seamless steel or lightweight alloy

42
Q

D cylinder contains

A

350L of O2

43
Q

E cylinder contains

A

625 L of O2

44
Q

M cylinder contains

A

3000 L of O2

45
Q

G cylinder contains

A

5300 L of O2

46
Q

H cylinder contains

A

6900 L of O2

47
Q

(Nonferrous) oxygen wrenches

A

Wrenches that are made of plastic or of metals that do not contain iron

48
Q

Pressure regulators make a safe pressure of?

A

Uses a pressure of 30-70 psi

49
Q

Humidifier

A

A device connected to the flow meter to add moisture to the dry oxygen coming from an oxygen cylinder

50
Q

Hazards of O2 medical and non medical

A

Non medical

  • if punctured can become a middle
  • oxygen supports combustion
  • oxygen and oil do not mix severe reaction cause an explosion

Medical

  • oxygen toxicity or air sac collapse by too much O2 in lungs
  • infant eye damage - over a long period (days) can develop scar tissue on retina of infants eye
  • respiratory depression or arrest - common in COPD patients
51
Q

Partial rebreather

A

9-10 L/min

40-60% O2

52
Q

B.U.R.P maneuver

A

Method using index and thumb pushing on thyroid cartilage upward and to the right for paramedic to see larynx
- Bringing Up and to the Right Position-

53
Q

Most systems have a standard fitting ?

A

Standard fitting is 15/22 to ensure a proper fit with other respiratory equipment, face masks, and endotracheal tubes