Component 3: Airway Management Techniques and Tools Flashcards
This deck is a review of airway management tools and techniques.
Differentiate visceral pleura and parietal pleura.
- Visceral pleura is the slippery outer membrane encompassing the lung tissue.
- Parietal pleura lines the inside of the thoracic cavity.
What is the fluid between the two pleura membranes called?
pulmonary surfactant
What nerve stimulates the diaphragm muscle to contract?
phrenic nerve
Where is the heart located in the thoracic cavity?
mediastinum
Define:
ventilation
It is the physical action of moving air in and out of the lungs.
Define:
oxygenation
It is the loading of oxygen molecules onboard the hemoglobin in the bloodstream.
Define:
respiration
It is the exchange of oxygen and carbon dioxide in the capillaries on the alveoli and other tissues of the body.
(O2), (CO2)
What are the two actions of ventilation?
inhalation and exhalation
Why is it important to create or secure a patent airway for a patient without a gag reflex?
A patient with no gag reflex cannot maintain a patent airway. We must provide a patent airway for oxygenation and possible positive pressure ventilation if needed.
(PPV)
True or false.
There is no difference between internal and external respiration.
False
Internal respiration occurs at a cellular level for tissues and organs.
External respiration is the initial action of breathing air in, and the gas exchange at the alveolar level.
What is it called when the cells can no longer metabolize the oxygen deprivation?
anaerobic metabolism
Fill in the blank.
The ________ is the most common airway obstruction.
tongue
True or false.
If the patient has a suspected spinal injury, it is appropriate to use a jaw-thrust maneuver.
True
The head-tilt, chin-lift maneuver may complicate any underlying injuries to the cervical spine.
Describe:
adequate breathing
- a normal respiratory rate (12 to 20 breaths/min),
- a regular pattern of inhalation and exhalation,
- lung sounds will be clear and equal bilateral,
- equal chest rise and volume
A patient is unconscious, unresponsive, and has snoring respirations at 5 breaths/min. What are the steps for airway and ventilation management?
- If there is a suspected spinal injury, open the airway with a jaw-thrust maneuver maintaining c-spine alignment.
- If no injury is suspected, open the airway with a head-tilt/chin-lift maneuver.
- Suction as necessary.
- Size and insert an oral pharyngeal airway, and place the mask of the bag-valve-mas over the patient’s mouth and nose.
- Ventilate while watching for equal chest rise and fall.
Describe:
agonal gasps and/or breathing
It is described as intermittent and inadequate gasps.
List the muscles used when the patient is demonstrating labored or difficulty breathing.
Dyspnea
- Sternocleidomastoid
- Pectoralis major
- Intercostals
- Abdominal
What is the breathing pattern called that has irregular pattern(s) with periods of apnea?
Cheyne-Stokes
List the causes of inaccurate pulse oximetry readings.
- nail polish
- carbon monoxide poisoning
- severe distal vasoconstriction (chronic hypoxia, smoking, hypothermia)
- hypovolemia
- dirty fingers/nail beds
Can you think of any more?
Describe:
capnography
It measures end-tidal carbon dioxide and provides a numerical reading and graph of CO2 in the patient’s respirations.
What is the normal capnography mm Hg reading range?
35 to 45 mm Hg
List the types of airway obstruction(s).
- relaxed tongue
- foreign bodies (food, objects, dentures)
- swelling of the airway tissues
- trauma
- emesis/vomiting
Can you think of any more?
What is the concern if we insert the suction catheter too far into the semi-conscious patient’s oropharynx?
- stimulation or triggering of the patient’s gag reflex
- inducing vomiting
When is inserting an oropharyngeal indicated?
(OPA)
In unresponsive patients (breathing or apneic) when their gag reflex is no longer intact.
True or false.
When measuring the appropriate size of an oropharyngeal airway for placement, we measure from the corner of the mouth to the tip of the earlobe.
True
Describe:
The measurement of a nasopharyngeal airway.
NPA
An NPA should be measured from the tip of the patient’s nose to the tip of their earlobe.
When providing positive pressure ventilation, you notice the patient’s dentures have come loose. Should you continue to ventilate or remove the dentures and then continue to ventilate?
PPV
Remove the dentures to prevent them from becoming an airway obstruction.
What type of lubricant is used when preparing a nasopharyngeal airway for insertion?
water-soluble lubricant
True or false.
The BVM should be hooked up to 15 LPMs of oxygen (O2).
True
Upon inhalation, does the diaphragm contract or relax?
When inhaling, the diaphragm will contract to pull downward, drawing air inward.
True or false.
When applying a Non-Rebreather Mask, the mask should be prefilled with no less than 10 L/min.
True
If the non-rebreather mask is filled with less than 10 L/min, the reservoir bag will not fill appropriatly.
What is the benefit of cracking the valve on the oxygen (O2) tank prior to assembling the regulator/gauge?
To blow out any lint or debris that may obstruct the flow of oxygen (O2) through the regulator.
For safety, when clearing the valve, point the opening away from anyone, including yourself.
What is the oxygen (O2) flow rate for a nasal cannula?
between 1 and 6 L/min
List oxygen-delivery devices
- nasal cannula
- non-rebreather mask
- BVM with reservoir
- mouth to mask
- venturi mask
What does the presence of cyanosis indicate?
It indicates that the patient is suffering from poor circulation and/or poor oxygenation.
What does it mean if the patient is apneic?
It refers to the absence of breathing, meaning the patient is not breathing.
Define:
In reference to airway management, define aspiration.
It is vomitus, liquids, blood, or other foreign substances entering the lungs.
How much supplemental oxygen (O2) is administered when using a non-rebreather mask?
Up to 90% O2 on inspiration.
How do we prefill the reservoir bag before we apply the mask to the patient?
Place a gloved finger over the one-way valve of the non-rebreather mask, and prefill the reservoir bag.
What is the point where the left and right mainstem bronchi bifurcate?
They bifurcate at the carina.
You are providing positive pressure ventilation (PPV) with a bag-valve-mask and are not getting any chest rise. What should you do?
BVM
We should re-adjust and re-evaluate the airway because there is non-compliance with PPV.
List contraindications for the application of Continuous Positive Airway Pressure.
CPAP
- The patient is apneic.
- Signs and/or symptoms of chest trauma or a pneumothorax.
- The patient is actively vomiting.
- The patient cannot follow commands.
- A patient with a tracheostomy.
If we are providing positive pressure ventilation (PPV) too aggressively with too much oxygen (O2), what will most likely develop, and what is the concern?
- Gastric distention will develop and cause an additional airway concern of emesis/vomit.
- It may lead to aspiration when being too forceful and aggressive when providing PPV with a bag-valve-mask (BVM).
Describe:
Describe how to perform a jaw-thrust maneuver.
With a supine patient:
- Place the head in the in-line position.
- Place your fingers behind the angle of the jaw and lift, or pull up with your fingers.
This technique will pull a relaxed tongue off the back of the pharynx.
What is the amount of air (in mLs) that we move in and out in one breath called?
tidal volume
When inserting a nasopharyngeal airway (NPA), where should the bevel be?
It should be placed against the nasal septum whether right or left nare insertion.
True or false.
The nasopharyngeal airway (NPA) will hold the tongue of the posterior aspect of the throat.
False
A correctly placed NPA’s tip will be seen posterior to the uvula.
An oropharyngeal airway (OPA) will displace the tongue to allow for air to pass.
What anatomy separates the upper from the lower airways?
The larynx separates the upper and lower airways, and is protected by the cricothyroid cartilage.
True or False
Oxygen (O2) is a prescribed medication.
True
When providing rescue breaths for an adult, how often do we provide ventilation?
One breath (over one second) every five to six seconds.
True or false.
When placing a nasal cannula on a patient, it is best to have the oxygen flow meter set.
False
Make certain the flow meter is off, apply the cannula, and then set the flow between 1 and 6 L/min.
What is the easiest way to quickly master your knowledge of airway management, respiration, and ventilation for paramedic training?
Brainscape’s EMT-P (1) Airway, Respiration, and Ventilation Flashcards
