Chapter 11 - Airway Management Flashcards
tool for maintaining airway
OPA(unless gag reflex is present), NPA
After maintaining?
Use BVM to provide positive pressure to maintain patent airway
Alveoli
Place for gas exchange between O2 and CO2, surrounded my capillary beds to keep them in place and blood for the process
Normal lung sounds
Clear, equal, bilateral
Artificial ventilation
tools for providing ventilation
parts that need o2
Heart, lungs, kidney, brain, liver - they need it there is AMS
Upper airway and lower airway
Upper ends at larynx and lower starts from trachaea
Nose hairs
Filters waste out of the air we breathe for quality air and humidifies it
Nasopharynx
Lined with ciliated mucous membranes to keep contaminants out
Oropharynx
to prevent food and liquid from entering the larynx during swallowing, posterior of the oral cavity
Larynx
Trachea
Which cavity has the heart and great vessels(vena cavae and aorta)?
Thoracic cavity
Ventilation
Physical act of inhaling and exhaling
Respirations
o2 co2 exchange in the alveoli
oxygenation
active process of loading oxygen onto the hemoglobin on the rbcs in the blood
hemoglobin
product of rbcs; blood protein that carries o2
WBCS
fights infection
platelets
clots to prevent bleeding
plasma
fluid that carries all the components like a river
C3 C4 C5
parts of the spine(cervivcal spine) that keeps you alive
Phrenic nerve
originates from the C3C4C5 nerves that sends signals to diaphragm to breathe
What does the brain need?
Sugar, o2, temperature (warm)
STUDY THE AIRWAYS
What does the mediastinum contain?
Heart, great vessels, esophagus, trachea, major bronchi, lots of nerves
Nasal cannula requirements
1-6 Lpm at least 2
32-44% O2
for COMFORT
Tidal Volume
Amount of air in ml that is moved into or out of the lungs in one breath
Inhalation
Exhalation
COPD
Chronic Obstructive Pulmonary Disease: Emphysema, Chronic Bronchitis
Emphysema
Alveoli problem: They shrivel and gas exchange isn’t right(poor exchange)
Chronic Bronchitis
CO2 retention; inflammation of the bronchioles
Regulation of ventilation
Asthma
Bronchioles get inflamed and and constrict them
Chemoreceptors
They monitor O2 levels, CO2, H ion conc, and ph of CSF
Ventilation/Perfusion ratio and mismatch
No gas exchange
lack of o2 in bloodstream
co2 recirculated in blood stream
Factors affecting pulmonary ventilation
infections, allergic reactions, unresponsivenes(tongue obstruction), trauma
Suction guidelines
15 sec adult
10 sec child
5 sec infant
put to where you can see and circular motion on way out, remove immediately if gag reflex presented
Factors affecting respiration
atmospheric pressure, partial pressure pf O2, pneumonia, pulmonary edema, Copd/emphysema
Circulatory compromise
simple or tension pneumothorax
open pneumothorax
hemothorax
hemopneumothorax
Simple pneumothorax/tension
partial collapse of the lung and complete
open pneumothorax
hemothorax
internal bleeding
hemopneumothorax
Adequate breathing
12-20 per min
regular pattern of breathing and exhalation
bilateral clear equal
chest rise normal
adequate depth - tidal volume
Non rebreather mask req
10-15 Lpm
45%-64% o2
for labored breathing
Bag-valve mask req
15+ Lpm
65-100% o2
for unresponsive, less than 8pm or more than 28pm, irregular breathing, shallow breathing
rescue breathing req
1 breath every 5-6 seconds
Recognize abnormal breathing
unequal inadequate chest expan
increased effort
shallow depth
skin that is pale, cyanotic, cool, or moist
skin pulling around ribs or around clavicles - retractions
Cheyne stokes respirations
patients with stroke or head injuries
may appear to be breathing after the heart has stopped
called agonal gasps
Attaxic, Kussmaul resp
A - irregular or unidentifiable pattern, may follow head injury
K - Deep rapid res, common in patient with metabolic acidosis, seen in diabetic patients with high blood sugar
Assessment of respiratory in spite of normal ventilation
LOC/Skin color, pulse ox for oxygenation
End tidal CO2 and meaning of results
Measurement of the maximal CO2 at the end of an exhaled breath
should be 35-45 mm/hg
low co2 - hyperventilation, decreased co2 return to lungs, reduced co2 production at cellular level
high co2 - ventilatory inadequacy or apnea
Indications/Contra for OPA
Ind: Unresponsive without gag, apnea
Indications/Contra for NPA
way to maintaining airway
Recovery position to maintain a clear one who is unconscious, not injured and is breathing on his own, typically onto to take pressure off the heart
Nasal Cannula indications/contra
Partial rebreather mask
Venturi mask
Tracheostomy mask
PPV
Gastric distention(Meaning)
Ways to prevent or alleviate gastric distention
Automatic transport ventilator
CPAP
continuous positive airway pressure
at least 25 Lpm
for severe shortness of breath
can hear rhonchi or rales for patients who use them and are blue
PPV for maintaining patent airway
once started, needs to be on until arrival at hospital
What cpap do?
increases lung pressure
opens collapsed alveoli
pushes more o2 across alveoli membrane
pushes interstitial fluid back into pulmonary circulation
Indications of CPAP
Contra for CPAP
Complications for CPAP
Stomas
Tracheostomy tubes
