EMR Chapters 9-11: CPR Flashcards
Path that Oxygen Takes
The nose is the primary path for air to enter and leave the system. As air enters, the nose filter is it, and helps moisten it. The mass is the secondary path for air to enter and leave. Air then travels down the pharynx or throat and past the epiglottis. From there, it passes through the larynx, or voice box, and enters the trachea, sometimes called the windpipe, and is the air passage to the lungs. Travels to the lungs through a structure called the bronchial tree, which is formed by tubes that branch from the trachea. It’s two main branches are the right, and left main stem bronchi one for each lung. They branch into secondary bronchi in the lobes of the lungs. The secondary bronchi, then branch into smaller bronchioles, and eventually into alveoli, microscopic air sacs, where the exchange of gases takes place.
An open and clear airway
Before a breath can be taken, there must be an open and clear path into the lungs. This path is commonly called the airway and consists of the passages that make up the nose (nasopharynx), mouth (oropharynx), throat (pharynx), and trachea. When an airway is open and clear, it is said to be patent. Assessing for an insuring a patent airway will be one of the very first steps in the assessment of any patient you encounter. common causes of airway obstruction include the patient’s own tongue, secretions, vomit, a foreign object, such as a piece of food, or a small toy, and swelling of the tissues that form the airway.
Signs of Adequate Breathing
- adequate tidal volume and depth of breathing is normal
- sounds; listen for air entering and leaving the nose and mouth (should be quiet)
- Rate of breathing is regular (not too fast or too slow)
- Skin color of the patient is normal (not blue, flustered, or pale)
- Responsiveness; a responsive patient who is not having difficulty breathing is almost always breathing normally
- work of breathing is normal
Tidal volume
The amount of air being moved into and out of the lungs with each breath
Dyspnea
Difficult or labored breathing
Signs of Abnormal Breathing
A patient who is unable to breathe, and normally is said to have difficulty breathing or be in respiratory distress. This is sometimes called shortness of breath, and the medical term for this is dyspnea. The following are common signs and symptoms of abnormal breathing:
- Increased work of breathing
- Shallow or absent rise and fall of the chest
- little or no air heard, or felt at the nose or mouth
- noisy breathing or gasping sounds
- Breathing that is irregular, too rapid, or too slow
- Breathing that is too deep or labored, especially in infants and children
- Use of accessory muscles in the chest, abdomen, and around the neck
- Nostrils, that flare, when breathing, especially in children
- Skin that is pale or cyanotic (tinted blue)
- or leaning forward in a tripod position in an effort to make breathing easier
Accessory muscles
Muscles of the neck, chest, and abdomen that can assist during respiratory difficulty
Agonal respirations
Another form of abnormal breathing that is common during cardiac arrest. It is an abnormal breathing pattern characterized by slow, shallow, gasping breaths that typically occur following cardiac arrest
Rescue Breathing
Rescue breathing is the process of providing manual ventilations for a patient who is not breathing on his or her own, or who is unable to breathe adequately. There are many terms for this process, including positive pressure ventilation and pulmonary resuscitation. Rescue breaths are indicated when a patient is unable to breathe within an adequate rate and volume to sustain life. Rescue breaths are not appropriate for a patient who is responsive or an unresponsive. Patient who is breathing with a normal rate and tidal volume. the atmosphere contains about 21% oxygen. The air exhaled from your lungs can contain up to 16% oxygen. This is more than enough oxygen to keep most patients biologically alive until they can receive supplemental oxygen.
Positive pressure ventilation
The process of using external pressure to force air into a patient’s lungs, such as with mouth to mask or bag mask ventilations
Pulmonary resuscitation
The act of breathing for a patient who is unable to breathe for himself. Also called rescue breathing or artificial ventilation.
Stoma
A surgical opening in the skin. A stoma is created on the anterior neck when a patient has a tracheostomy.
Gastric distention
Inflation of the stomach because air gets into it.
Signs of partial airway obstruction
A patient who is having difficulty breathing, may have only a partial obstruction, and may still be able to move some air. The signs of partial airway obstruction include the following:
- noisy breathing, such as these symptoms:
- Snoring is evidence of a partial obstruction usually caused by the tongue
- Gurgling is usually caused by fluids or blood in the oropharynx and or upper airway
- Stridor is a high-pitched sound, typically on inspiration, caused by swelling of the larynx. Also referred to as crowing.
- Wheezing is a high-pitched, whistling sound, usually due to swelling or spasms of the lower airway. It is more common during exhalation.
- Increased work of breathing with skin that is pale or blue at the lips or nail beds.
Signs of complete airway obstruction
When the airway is completely obstructed, the responsive patient will be unable to speak, breathe, or cough. The patient will often grasp his or her neck and open his or her mouth, which is the universal sign of choking. The unresponsive patient will not have any of the typical chest movements, or the other signs of good air exchange.
