Lecture 6: Airway

Question 1

What is the Clawson system?

Answer 1

Classification of EMS calls

Question 2

What is trismus?

Answer 2

Spasm of the jaw muscles due to epileptic activity

Question 3

What can obstruct the airway?

Answer 3

tongue
broken teeth
mouth guard
gum
chewing tobacco
vomit
food

Question 4

what are the three techniques for choking?

Answer 4

Bent-over backblows
Abdominal thrusts (chest thrusts for small rescuer/pregnant/obese)
Chest thrusts

Question 5

What are some signs and symptoms of anaphylactic reaction?

Answer 5

narrowing of brionchioles
dilation of blood vessels
skin lesion

respiratory: difficult, distress, arrest
cardiovascular: shock, cardiac arrest
gastro-intestinal: nausea, vomiting, diarrhea, abdominal pain
skin: urticaria, angioedema, redness
other: anxiety, feeling of imminent death

Question 6

When is it truly an anaphylactic reaction?

Answer 6

when 2 or more body systems are involved

Question 7

When could you give a repeat dose of epinephrine for anaphylaxis?

Answer 7

15 minutes after the first dose
Half life of epinephrine is 5min

Question 8

What are the factors to rule in an allergic reaction when someone is known to be allergic?

Answer 8

recent contact with causal agent <12hours ago
and
first sign of allergic reaction:
difficulty breathing
weakness
fainting
itchiness
urticaria

Question 9

What are the factors to rule in an allergic reaction when someone is NOT known to be allergic?

Answer 9

recent contact with causal agent <12 hours ago
and
respiratory distress
or
circulatory failure
or
visible edema of the tongue

Question 10

What are the effects of epinephrine?

Answer 10

reverses the effect of the anaphylaxis

dilates bronchioles
increases blood pressure
increases pulse, may cause palpitations
anxiety, trembling, nausea, vomiting
effects are of short duration

Question 11

What should you verify before administering an EpiPen?

Answer 11

6 rights of medication
medication is clear not cloudy
expiration date

Question 12

Which way should you always suction?

Answer 12

Always suction on the way out

Question 13

How long should you suction for when not vomiting?

Answer 13

adult: 15sec
child: 10sec
baby: 5 sec

Question 14

What are common causes of respiratory distress?

Answer 14

hyperventilation, asthma anaphylaxis, chest injury

Question 15

What are the signs and symptoms of respiratory distress?

Answer 15

abnormal breathing
abnormal skin color (usually moist, flushed, pale, ashen, bluish)

face is blue, the brain is too

Question 16

What is the general treatment of dyspnea (difficulty breathing)?

Answer 16

Loosen restrictive clothing
semi-sitting/tripod position
O2 depending on their SpO2

Question 17

What is the treatment for hyperventilation syndrome?

Answer 17

calm down, remove from stimuli
attempt to slow down breathing
No paper bags, use cupped hands for short periods of time
if cyanotic, paresthesia, lowering LOR give O2
As stimuli to breathe is CO2, pt may stop breathing with O2 admin, prep to ventilate

Question 18

What is bronchitis?

Answer 18

excessive mucous secretions, inflammatory changes

Question 19

What is emphysema?

Answer 19

Lungs unable to effectively exchange CO2/O2
Careful with hyper-oxygenation

Question 20

What is the pathogenesis of asthma?

Answer 20

muscle contraction, inflammatory reaction, increased mucous production, increased mucous viscosity, decreased air exchange due to spasm, swelling, secretions

Question 21

What are the S/S of asthma?

Answer 21

wheeze on exhalation
difficulty breathing
chest tightness
ineffective cough
headache
tight/irritated throat
mild cyanosis

Question 22

what can a bad asthma attack lead to?

Answer 22

it can progress to respiratory arrest, “ a silent asthmatic is not a good sign”

Question 23

What does a nebulizer do?

Answer 23

changes asthma medication from a liquid to a mist, so that it can easily inhaled into lungs

Question 24

What is the peak flow in a green zone asthma plan?

Answer 24

80% or more of personal best

Question 25

What is the peak flow in a yellow zone asthma plan?

Answer 25

50-80% of best

Question 26

What is the peak flow in a red zone asthma plan?

Answer 26

less than 50% of personal best

Question 27

What is the course of action for red zone asthma?

Answer 27

Safe place/ stress free environment
position of comfort/ posture of ease
take extra puffs of reliever meds/ don’t wait
use aero-chamber for better admin
take a dose of oral steroids meds
oxygen if available
seek care at urgent care facility

911 if in red zone
>15min
cyanotic
hard to talk/walk

Question 28

What is the opioid action plan?

Answer 28

obtain info about medication that all athletes are taking
know the signs and symptoms of an opioid overdose
have a naloxone kit and pocket mask available in fanny pack
have access to BVM/AED/ assistant within 3 min

Question 29

S/S of opioid overdose?

Answer 29

unresponsive
breathing labored, snore-like, ineffective, absent
pupils constricted

Question 30

What are the proper intervention steps of an opioid overdose?

Answer 30

911/ action plan activated
BLS provided as required
SAMPLE indicates possibility of intoxication/overdose
Naloxone available and admin
Do not delay admin if available, resume BLS right away
Naloxone repeated every 3 min until responsive
Provide post intervention/recovery care
Possible relapse, should not be left alone
Transfer of care to EMS

Question 31

Which nostril should you administer naloxone in?

Answer 31

Right nostril
then left nostril when repeated

Question 32

What are the signs and symptoms of hypoxia?

Answer 32

increased respiration
increased pulse
cyanosis
changes in LOC
restlessness
chest pain

Question 33

What should you administer O2 for?

Answer 33

shortness of breath
chest pain/MI
breathing difficulties
altered levels of consciousness
hemorrhage: external/internal
shock prevention/ treatment
polytraumatized

Question 34

When should you ventilate patient with BVM or PM?

Answer 34

if respirations are <10 or >30

Question 35

What is the max duration of a D cylinder?

Answer 35

15 minutes

Question 36

What is the difference between inhalation and ventilation?

Answer 36

inhalation: patient breathing but needs supplemental O2
ventilation: patient not breathing, must be given breaths ideally with supplemental O2

Question 37

What percentage of O2 does a nasal canula provide?

Answer 37

provides atmospheric O2 21% + 4% for every liter flow so if 4l/min
21% +(4x4)= 37%

Question 38

What are the industry standard for Oxygen cylinders?

Answer 38

D size cylinder
2000 psi full tank
should have at least 800psi on standby
change cylinder at 500psi
minimum cylinder pressure 200psi

Question 39

What are the precautions during oxygen delivery?

Answer 39

do not operate around flames/sparks
do not stand cylinder upright
do not use grease/oil/ petroleum products to lubricate
check oxygen flow before placing delivery device on victim
Once tank in use keep regulator on tank at all times