Lecture 6: Airway Flashcards
What is the Clawson system?
Classification of EMS calls
What is trismus?
Spasm of the jaw muscles due to epileptic activity
What can obstruct the airway?
tongue
broken teeth
mouth guard
gum
chewing tobacco
vomit
food
what are the three techniques for choking?
Bent-over backblows
Abdominal thrusts (chest thrusts for small rescuer/pregnant/obese)
Chest thrusts
What are some signs and symptoms of anaphylactic reaction?
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
When is it truly an anaphylactic reaction?
when 2 or more body systems are involved
When could you give a repeat dose of epinephrine for anaphylaxis?
15 minutes after the first dose
Half life of epinephrine is 5min
What are the factors to rule in an allergic reaction when someone is known to be allergic?
recent contact with causal agent <12hours ago
and
first sign of allergic reaction:
difficulty breathing
weakness
fainting
itchiness
urticaria
What are the factors to rule in an allergic reaction when someone is NOT known to be allergic?
recent contact with causal agent <12 hours ago
and
respiratory distress
or
circulatory failure
or
visible edema of the tongue
What are the effects of epinephrine?
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
What should you verify before administering an EpiPen?
6 rights of medication
medication is clear not cloudy
expiration date
Which way should you always suction?
Always suction on the way out
How long should you suction for when not vomiting?
adult: 15sec
child: 10sec
baby: 5 sec
What are common causes of respiratory distress?
hyperventilation, asthma anaphylaxis, chest injury
What are the signs and symptoms of respiratory distress?
abnormal breathing
abnormal skin color (usually moist, flushed, pale, ashen, bluish)
face is blue, the brain is too
What is the general treatment of dyspnea (difficulty breathing)?
Loosen restrictive clothing
semi-sitting/tripod position
O2 depending on their SpO2
What is the treatment for hyperventilation syndrome?
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
What is bronchitis?
excessive mucous secretions, inflammatory changes
What is emphysema?
Lungs unable to effectively exchange CO2/O2
Careful with hyper-oxygenation
What is the pathogenesis of asthma?
muscle contraction, inflammatory reaction, increased mucous production, increased mucous viscosity, decreased air exchange due to spasm, swelling, secretions
What are the S/S of asthma?
wheeze on exhalation
difficulty breathing
chest tightness
ineffective cough
headache
tight/irritated throat
mild cyanosis
what can a bad asthma attack lead to?
it can progress to respiratory arrest, “ a silent asthmatic is not a good sign”
What does a nebulizer do?
changes asthma medication from a liquid to a mist, so that it can easily inhaled into lungs
What is the peak flow in a green zone asthma plan?
80% or more of personal best
What is the peak flow in a yellow zone asthma plan?
50-80% of best
What is the peak flow in a red zone asthma plan?
less than 50% of personal best
What is the course of action for red zone asthma?
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
What is the opioid action plan?
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
S/S of opioid overdose?
unresponsive
breathing labored, snore-like, ineffective, absent
pupils constricted
What are the proper intervention steps of an opioid overdose?
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
Which nostril should you administer naloxone in?
Right nostril
then left nostril when repeated
What are the signs and symptoms of hypoxia?
increased respiration
increased pulse
cyanosis
changes in LOC
restlessness
chest pain
What should you administer O2 for?
shortness of breath
chest pain/MI
breathing difficulties
altered levels of consciousness
hemorrhage: external/internal
shock prevention/ treatment
polytraumatized
When should you ventilate patient with BVM or PM?
if respirations are <10 or >30
What is the max duration of a D cylinder?
15 minutes
What is the difference between inhalation and ventilation?
inhalation: patient breathing but needs supplemental O2
ventilation: patient not breathing, must be given breaths ideally with supplemental O2
What percentage of O2 does a nasal canula provide?
provides atmospheric O2 21% + 4% for every liter flow so if 4l/min
21% +(4x4)= 37%
What are the industry standard for Oxygen cylinders?
D size cylinder
2000 psi full tank
should have at least 800psi on standby
change cylinder at 500psi
minimum cylinder pressure 200psi
What are the precautions during oxygen delivery?
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
