Chapter 8 Flashcards
Oxygenation refers to
Process by which oxygen concentration increases within a tissue
Ventilation refers to
The mechanical exchange of air between the outside environment and the alveoli of the lungs
Cerebral oxygenation and oxygen delivery to other parts of the body provided by adequate airway management and ventilation remain
Most important components of prehospital patient care
Respiratory system serves to primary functions
To provide oxygen to the red blood cells which carry the oxygen to all of the body cells. To remove carbon dioxide from the body
Inability of the respiratory system to provide oxygen to the cells or inability of the cells to use the oxygen supplied results in
anaerobic metabolism And can quickly lead to death
Failure to eliminate carbon dioxide
Can lead to coma and acidosis
Lower airway begins at
The trachea
False cords
Or vestibular folds
The alveoli are the site of gas exchange where
The respiratory and circulatory system meet
Carbon dioxide is transported in three ways
In the plasma, bound to proteins such as hemoglobin, and buffered as bicarbonate
The size of each breath, called the title volume, multiply by the ventilatory rate for one minute equals
Minute volume
At rest, about 7 L of air must move in and out of the lungs each minute to maintain
Adequate carbon dioxide elimination and oxygenation
Evaluating a patient ability to exchange air involves accessing
Both ventilatory rate and depth
Metabolism normally occurs through
Glycolysis and the Krebs cycle to produce energy
Hypoxemia decreased oxygen level in the blood can result from
Decreased diffusion of oxygen across the alveolar capillary membrane
Hypoxia deficient tissue oxygenation can be caused by
The inability of the air to reach the capillaries usually because the airway is obstructed or the alveolar I are filled with fluid or debris. Decreased blood flow to the alveoli. Decreased blood flow to the tissue cells.
Hypo ventilation Kim results from
Obstruction of air flow through the upper and lower airways. Decreased expansion of the lungs as a result of direct injury to the chest wall or lungs. Loss of vanilla Tori drive, usually because of decreased neurologic function, most often after a Trumatic brain injury.
Hyperventilation can cause vasoconstriction which can be especially detrimental in the management of
Traumatic brain injury patient
Hypo ventilation results in
Carbon dioxide buildup, acidosis, and eventually death
Decrease minute volume can because by two clinical conditions related to decreased neurologic
Mechanical obstruction and a decreased level of consciousness
Hyperventilation occurs when
Alveolar ventilation is so great that carbon dioxide removal exceeds its production in metabolizing cells, thus leading to hypocapnia a decreased amount of carbon dioxide in the arterial blood
When carbon dioxide levels are below normal levels of 35 to 45 mmHg
Vasoconstriction begins to occur
Any maneuver that moves the mandible forward will
Pull the tongue out of the hypopharynx
The most significant complication of suctioning is
Suctioning for prolonged periods will produce hypoxemia, which produces significant detrimental effects at the tissue level in many organs
The most obvious clinical clue that the patient is becoming hypoxic
Cardiac abnormalities example tachycardia or dysrhythmias
Primary advantage of supraglottic airways is that they
May be inserted independent of the patient’s position which may be especially important in trauma patients with access an extrication difficulties or a high suspicion of cervical injury
Contra indications for a supra glottic airway
Intact gag reflex non-fasting recent meal known a Soffa Gille disease recent ingestion of caustic substances
In a patient with a perfusing rhythm ET CO2 monitoring capnography
Serves as the gold standard for determining ET tube placement
Percutaneous transtracheal ventilation. This technique while it provides for oxygenation does not support adequate ventilation for any length of time as a result rising levels of carbon dioxide will occur which can be tolerated for approximately 30 minutes after which formal airway management must be accomplished to prevent profound respiratory acidosis from developing this technique is temporizing measure to maintain Aisha nation until the defense of airway can be obtained to provide adequate ventilation
.
The title volume should be set using
5 to 7 mL per kilogram of the patients ideal body weight
Peep PEEP should be set initially at 5 cm of water
The setting will maintain what is known as physiologic Pete which is the amount of peep that is normally present in the airway prior to into
The high-pressure alarm and pressure relief pop off should be set at no more than
10 cm of water above the pressure needed normally ventilator patient peak inspiratory pressure
Capnography should be used to
Monitor ET tube placement and continuously monitor patient status during transport
Capnography or in title carbon dioxide ET CO2 monitoring has been used in critical care units for many years
.
Capnography measure is the partial pressure of carbon dioxide in a simple gas if the sample Is taken at the end of exhalation in a patient with good peripheral perfusion, it correlates closely to arterial PCO2. However in the multiple trauma patient with compromised perfusion, the correlation of ET CO2 to arterial PCO2 remains questionable
.
Burn patients should receive supplemental oxygen to maintain SPO2 greater than 95%, where as those with known or suspected carbon monoxide poisoning should receive 100% oxygen
.
As with all skills, training requires observation, critique, and certification initially and at least
Twice a year by the medical director or designee
