Module 7: Airway Flashcards
Define ventilation. What are the muscles involved? What are the two phases?
act of moving air in and out
muscles involved: diaphragm, intercostal muscles, pectorals
Phases: Inhalation (active) exhalation (passive)
What are the two goals of the respiratory system?
- bring in oxygen to create energy
- get out CO2 to maintain homeostasis
Where does gas exchange take place?
Between pulmonary capillaries and alveoli
If you stop breathing what gas would be kept in bloodstream?
CO2
What is respiration?
Gas exchange
what is the carbonic drive?
The brain stem controls ventilation based on feedback it receives regarding the amount of CO2 circulating in the blood. The higher the CO2, the more you breathe.
What is the hypoxic drive?
Body relies on low levels of oxygen to drive breathing due to high levels of carbon (often caused by smoking)
Compare carbonic drive to hypoxic drive
carbonic: high levels of Co2=Drive to breath
Hypoxic: low levels of O2=Drive to breath
Name some signs and symptoms of inadequate breathing
-unequal chest expansion
-tripod position
-increased effort
-shallow depth
-Pale, cyanotic, cool, or moist skin
- skin pulling in around ribs during inspiration
-abnormal skin color
-altered mental status
-low pulse ox
What are some interferences with pulse oximetry?
nail polish, cold fingers, carbon monoxide poisoning
What is the psi for a full tank and what is the psi for an empty tank?
full: 2000
empty: 500
an NRB reuqires an LPM of ___ while a nasal cannula requires an LPM of ____
NRB:10-15
Nasal cannula: 2-6
An NRB delivers __% oxygen. The bag should be ___ full at all times
90%, 3/4ths
A nasal cannula delivers __ to __% oxygen
24-44%
What is the best way to ventilate a pt with a tracheostomy?
create a seal over the stoma, typically by using a pediatric mask
What should you do if a tracheostomy tube falls out?
leave it out, do not try to reposition
When is humidified oxygen useful?
Burns
pediatric patients
long transports
Should you immediately connect PPV to supplemental oxygen?
No, wastes time
Should you use CPAP on an unresponsive patient?
No, only responsive patients
Who approves use of CPAP?
Medical director
A pt is effectively able to ventilate but requires supplemental oxygen. What device should be used?
nasal cannula or NRB
A pt has worsening dyspnea but is still conscious. What device should be used?
CPAP
A patient is in respiratory failure and/or is apneic. What device should be use?
BVM or pocket face mask
Can a nasal cannula, NRB, or CPAP cause the chest to rise?
No, only possible with BVM or pocket face mask
Describe characteristics of an OPA. What sort of patients are they used on? What are they used for? How are they inserted? What are the contraindications?
-Unresponsive pts
-prevents tongue from obstructing airway
-Inserted at 180 or 90 degree angle, follows contour of tongue
-not for pts with gag reflex
Describe characteristics of an NPA. What sort of patients are they used on? How are they inserted? What sort of pts should they NOT be used on?
-used on pts with gag refliex or clenched teeth
-measured in one way
-Needs to be lubricated
- CANNOT be used on pts with facial trauma or w cerebral spinal fluid
How many mmHg should suction devices attain?
-300mmHg
If secretions are too large to suction, what should EMT do?
Roll pt to side and clear airway with gloved finger
A rigid suction is also called___
yankauer catheter
What must be done for neutral alignment in pediatric pts?
Put a towel under them so their neck is straight
What should you do for a pt with dentures when it comes to airway obstruction?
Depends. If they are broken dislodged, remove. If securely in, keep them.
In a healthy individual, the primary stimulus to breathe is a(n):
1. decreased level of CO2 in blood
2. Increased level of O2 in blood
3. Increased level of CO2 in blood
4. Decreased level of O2 in blood
- Increased level of CO2 in blood
A 22-year-old male patient is having an active seizure. How should you manage his airway?
Insert an NPA
Breathing is controlled by an area in the
1. spine
2. diaphragm
3. lungs
4. brain stem
brain stem
In which of the following patients would a nasopharyngeal airway be contraindicated?
1. a pt who fell 20 feet and hit their head
2. an unconscious pt w an intact gag reflex
3. a semiconscious pt with a gag reflex
4. an unconscious pt who gags when you insert an NPA
- a pt who fell 20 feet and hit their head
The EMT should assess a patient’s tidal volume by:
1. assessing for cyanosis
2. observing adequate chest rise
3. counting respiratory rate
4. measuring oxygen saturation
- observing adequate chest rise
You are delivering oxygen to a patient with a nasal cannula at 4 L/min when he begins to complain of a burning sensation in his nose. You should:
1. apply an NRB
2. attach oxygen humidifier
3. increase flow rate to 6 L/min
4. remove nasal cannula
- attach oxygen humidifier
Which is true about a child’s airway compared to an adult
1. airway less deeply curved
2. trachea is more flexible
3. tongue is proportionally larger
4. trachea is larger
- airway less deeply curved
- trachea is more flexible
- tongue is proportionally larger
