chapter 11 - airway management Flashcards
The upper tract or the passage above the larynx, which includes the nose, mouth and throat
Airway
A side-lying position used to maintain a clear airway in unresponsive patients who are breathing adequately and do not have suspected injuries to the spine, hips or pelvis
recovery position
Improper placement of an advanced airway device into the esophagus rather than into the trachea
esophageal intubation
A liquid protein substance that coats the alveoli in the lungs, decreases alveolar surface tension, and keeps the alveoli expanded
surfactant
Visualization of the airway with a laryngoscope
direct laryngoscopy
Visualization of the vocal chords, and thereby placement of the endotracheal tube, that is facilitated by use of a video camera and monitor
video laryngoscopy
The exchange of air between the lungs and the environment
ventilation
Thin membrane that covers the lungs
visceral pleura
Movements in which the skin pulls in around the ribs during inspiration
retractions
Technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used for patients who may have a cervical spine injury
jaw-thrust maneuver
The biochemical processes that result in production of energy from nutrients within the cells
metabolism
The process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs
oxygenation
The space in between the vocal chords that is the narrowest portion of the adult’s airway; also called the glottic opening
glottis
A technique in which oxygen administered via a high-flow nasal cannula is left in place during an intubation attempt, allowing for continuous oxygen delivery into the airways during all phases of the procedure
apneic oxygenation
Irregular, ineffective respirations that may or may not have an identifiable pattern
ataxic respirations
The amount of air (in milliliters) that is moved into or out of the lungs during one breath
tidal volume
The process of exchanging oxygen and carbon dioxide
respiration
A harsh, high-pitched respiratory sound, generally heard during inspiration, that is caused by partial blockage or narrowing of the upper airway
stridor
The volume of air that reaches the alveoli. It is determined by subtracting the amount of dead space air from the tidal volume
alveolar ventilation
A system established for portable cylinders to ensure that a regulator is not connected to a cylinder containing the wrong type of gas
pin-indexing system
An accumulation of air or gas in the pleural cavity
pneumothorax
The part of the pharynx that lies above the level of the roof of the mouth, or palate
nasopharynx
A hollow, cylindrical device used to remove fluid from the patient’s airway
suction catheter
The two nerves that innervate the diaphragm; necessary for adequate breathing to occur
phrenic nerves
The process of providing oxygen, often in combination with ventilation, prior to intubation in order to raise the oxygen levels of body tissues; a critical step in advanced airway management
preoxygenation
The amount of air that can be forcibly expelled from the lungs after breathing in as deeply as possible
vital capacity
Airway adjunct inserted into the mouth of an unresponsive patient to keep the tongue from blocking the upper airway and to facilitate suctioning the airway, if necessary
oropharyngeal airway
A protective item, such as a pocket mask with a valve, that limits exposure to a patient’s body fluids
barrier device
Bypassing of oxygen-poor blood past nonfunctional alveoli to the left side of the heart
intrapulmonary shunting
The use of muscles of the chest, back and abdomen to assist in expanding the chest
labored breathing
A safety system for large oxygen cylinders, designed to prevent the accidental attachment of a regulator to a cylinder containing the wrong type of gas
American Standard Safety System
Metabolism that takes place in the absence of oxygen; the main by-product is lactic acid
anaerobic metabolism
The volume of air moved through the lungs in 1 minute minus the dead space
alveolar minute volume
The amount of carbon dioxide present at the end of an exhaled breath
end-tidal CO2
A device with a one-way valve and a face mask attached to a ventilation bag
bag-mask device
Occurs when a foreign body partially obstructs the patient’s airway
mild airway obstruction
A collection of blood in the pleural cavity
hemothorax
A tubular structure that extends vertically from the back of the mouth to the esophagus and trachea
oropharynx
A term used to describe the degree of distress in a patient with a mild airway obstruction
poor air exchange
The act of air moving into and out of the lungs during chest compressions
passive ventilation
Abnormal breathing pattern characterized by slow, gasping breaths, sometimes seen in patients in cardiac arrest
agonal gasps
Open, clear of obstruction
patent
A complex structure formed by many independent cartilaginous structures that all work together
larynx
A high-pitched, whistling breath sound that is most prominent on expiration, and which suggests an obstruction or narrowing of the lower airways
wheezing
A combination mask and reservoir bag system that is the preferred way to give oxygen in the prehospital setting
nonrebreathing mask
The air that remains in the lungs after maximal expiration
residual volume
The active, muscular part of breathing that draws air into the airway and lungs
inhalation
The exchange of gases between the lungs and the blood cells in the pulmonary capillaries
external respiration
A method of ventilation used primarily in the treatment of critically ill patients with respiratory distress
continuous positive airway pressure
A noninvasive method to quickly and efficiently provide information on a patient’s ventilatory status, circulation, and metabolism
capnography
A normal reflex mechanism that causes retching
gag reflex
Any portion of the airway that does contain air and cannot participate in gas exchange, such as the trachea and bronchi
dead space
Large, semi-rigid suction tips recommended for suctioning the pharynx
tonsil tips
A flexible device that is inserted between the glottis under direct laryngoscopy
gum elastic bougie
Deficient oxygen concentration in the tissues
hypoxia
An oxygen-delivery device in which oxygen flows through two small, tubelike prongs that fit into the patient’s nostrils
nasal cannula
Any airway manipulation that induces the production of aerosols that may present a risk for airborne transmission of pathogens, such as CPR
aerosol-generating procedure
Absence of spontaneous breathing
apnea
Point at which the trachea bifurcates (divides) into the left and right main stem bronchi
carina
Subdivision of the smaller bronchi in the lungs; made of smooth muscle and dilate or constrict in response to various stimuli
bronchioles
Insertion of an endotracheal tube directly through the larynx between the vocal chords and into the trachea to maintain and protect an airway
endotracheal intubation
A ventilation device attached to a control box that allows the variables of ventilation to be set
automatic transport ventilator
The volume of air that moves in and out of the lungs per minute
minute volume
The process of replacing nitrogen in the lungs with oxygen to maintain a normal oxygen saturation level during advanced airway management
denitrogenation
A body part or condition that appears on both sides of the midline
bilateral
Monitor the levels of oxygen, carbon dioxide, and pH of the cerebrospinal fluid and then provide feedback to the respiratory centers to modify the rate and depth of breathing based on the body’s needs at any given time
chemoreceptors
Airway adjunct inserted into the nostril of an unresponsive patient or a patient with an altered level of consciousness who is unable to maintain airway patency independently
nasopharyngeal airway
Metabolism that can proceed only in the presence of oxygen
aerobic metabolism
The exchange of gases between the blood cells and the tissues
internal respiration
A cyclical pattern of abnormal breathing that increases and then decreases in rate and depth, followed by a period of apnea
Cheyne-Stokes respirations
Thin white bands of tough muscular tissue that are lateral borders of the glottis and serve as the primary center for speech production
vocal chords
The ability of the alveoli to expand when air is drawn in during inhalation
compliance
Movement of a gas from an area of higher concentration to an area of lower concentration
diffusion
Increased carbon dioxide level in the bloodstream
hypercarbia
The use of a capnometer, a device that measures the amount of expired carbon dioxide
capnometry
An opening through the skin and into an organ or other structure
stoma
The term used to describe the amount of gas in air or dissolved in fluid, such as blood
partial pressure
Thin membrane that lines the chest cavity
parietal pleura
In the context of the airway, the introduction of vomitus or other foreign material into the lungs
aspiration
A condition in which chronically low levels of oxygen in the blood stimulate the respiratory drive
hypoxic drive
An assessment tool that measures oxygen saturation of hemoglobin in the capillary beds
pulse oximetry
Space within the chest that contains the heart, major blood vessels, vagus nerve, trachea, major bronchitis, and esophagus
mediastinum
A condition in which air fills the stomach, often as a result of high volume and pressure during arterial ventilation
gastric distention
A surgical procedure to create an opening (stoma) into the trachea
tracheostomy
Occurs when a foreign body completely obstructs the patient’s airway
severe airway obstruction
An accumulation of air or gas in the pleural cavity that progressively increases pressure in the chest and that interferes with cardiac function, with potentially fatal results
tension pneumothorax
The passive part of the breathing process in which the diaphragm and the intercostal muscles relax, forcing air out of the lungs
exhalation
Shortness of breath or difficulty breathing
dyspnea
A combination of two movements to open the airway by tilting the forehead back and lifting the chin; not used for trauma patients
head tilt-chin lift maneuver
A term used to distinguish the degree of distress in a patient with a mild airway obstruction
good air exchange
A condition of excessive oxygen consumption resulting in cellular and tissue damage
oxygen toxicity
