Respiratory & Airway Terminology Flashcards
tidal volume
amount of air moved in one breath (500mL = avg. adult)
dead space
amount of air that is not available for gas exchange; moved in ventilation but does not reach alveoli (150mL = avg. adult)
minute volume
amount of air moved into and out of the lungs per minute
MV = TV x RR
hypoxia
low oxygen levels in the cells
hypoxemia
low oxygen levels in the arterial blood
ventilation
the process of air movement into and out of the lungs
perfusion
the circulation of blood through the lung tissues (alveoli)
diffusion
the process of gas exchange (carbon dioxide and oxygen)
inspiration (inhalation)
active process that creates negative pressure
expiration (exhalation)
passive process that generates positive pressure
where is the respiratory center housed?
in the brainstem (specifically the medulla oblongata)
crackles (rales) - lung sounds
fine, bubbling sound heard on auscultation of the lung; produced by air entering the distal airways and alveoli that contain serous secretions
rhonchi - lung sounds
abnormal, coarse, rattling respiratory sounds, usually caused by secretions in the bronchial airways
stridor - lung sounds
abnormal, high-pitched, musical sound caused by an upper airway obstruction (subglottic)
wheezing
form of rhonchi, characterized by a high pitched, musical quality; produced in the lower airways (bronchioles)
tachypnea (respiratory patterns)
increased (fast) respirations
eupnea (respiratory patterns)
normal respirations
bradypnea (respiratory patterns)
decreased (slow) respirations
apnea
no respirations (not breathing)
Cheyne Stokes
abnormal respirations with regular, periodic breathing with intervals of apnea and a crescendo-decrescendo pattern of respirations
Biot’s
abnormal respirations characterized by regular deep inspirations followed by regular or irregular periods of apnea
Apneustic
abnormal rapid respirations associated with deep, gasping inspirations - most often associated with stroke or trauma
Kussmaul’s
rapid and deep respirations - most often associated with diabetic ketoacidosis (DKA) as a compensatory mechanism in an attempt to correct the body’s metabolic acidosis
head-tilt, chin-lift
means of correcting the blockage of the airway by the tongue, by tilting the head back and lifting the chin
- used when trauma is not suspected
jaw-thrust
used when trauma, or injury, is suspected to open the airway without causing further injury to the spinal cord in the neck
- if the patient is found unresponsive, then always consider it to be a traumatic injury
oropharyngeal airway (OPA)
used on patients without gag reflex, moves tongue forward as it curves back to pharynx
- measured from center of mouth to angle of jaw
- insert device along roof of mouth, rotation 180 degrees to sit anatomically (can insert in “normal” position in pediatrics)
nasopharyngeal airway (NPA)
used in patients with intact gag reflex, moves tongue and soft tissue forward to provide channel for air
- measured from patient’s nostril to the tip of the earlobe or to the angle to the jaw
- bevel always goes towards the nasal septum
nasal cannula
1-6L/min
24-44% oxygen concentration
nebulizer
nebulized albuterol, ipratopium, and epinephrine
- 4-6L/min
- 6-8 (mask)
non-rebreather mask
12-15L/min
80-100% oxygen concentration
bag valve mask
at least 15L/min
- deliver breath over 1 second of time, allow for adequate exhalation
- squeeze bag until you see chest rise, release bag
- avg. tidal volume in adult patient: 500mL
- avg. dead space in adult patient: 150mL
- 12 breaths per min in adults
- 20 breaths per min in pediatrics
oxygen cylinders
- filled under a pressure of 2,000-2,200 psi
- green color cylinders are commonly used in USA
at what psi is the safe residual pressure for oxygen cylinders (cylinder considered “empty”)?
200psi
suctioning
- air intake of at least 30L/min
- suction set at 80-120 for adults
what is the max seconds of suctioning for adults?
15 seconds
what is the max seconds of suctioning for children?
10 seconds
what is the max seconds of suctioning for infants?
5 seconds
rigid suction
- also called Yankauer tip
- larger opening than soft suction catheters
- used for suctioning large chunks of food, vomit, blood, teeth, thick secretions
soft suction
- also called flexible suction
- smaller opening than rigid suction
- can be passed through nasopharyngeal or endotracheal tube for suctioning
- come in various sizes (larger the number = larger the opening of catheter)
- not typically large enough to suction vomit or thick secretions
what does COPD stand for?
Chronic Obstructive Pulmonary Disease
COPD
umbrella term that covers both chronic bronchitis and emphysema
signs of chronic bronchitis
- typically overweight
- productive cough with sputum
- coarse rhonchi
- chronic cyanosis
- mild, chronic dyspnea
- resistance on inspiration and expiration
signs of emphysema
- thin, barrel-chest appearance
- nonproductive cough
- wheezing and rhonchi
- pink complexion
- extreme dyspnea on exertion
- prolonged inspiration (pursed lip-breathing)
- clubbing of fingers
COPD management
- oxygen and bronchodilators
- albuterol (2.5mg in 3mL)
- consider CPAP
- contact ALS
asthma
- bronchoconstriction and inflammation
- dyspnea
- intercostal retractions
- decreasing LOC
- inability to speak in complete sentences
- tachycardia
- tachypnea
- ETCO2 greater than 45mmHg
status asthmaticus
severe, prolonged asthma attack that has not been stopped with repeated doses of bronchodilators
what is the BLS prehospital treatment aimed at for asthma?
bronchodilation (albuterol)
what is the ALS prehospital treatment aimed at for asthma?
- bronchodilation
- reducing inflammation
- relaxing the smooth muscle of the airways
management of asthma
- oxygen and bronchodilators
- albuterol (2.5mg in 3mL)
- consider CPAP
- contact ALS
pneumonia
- virus or bacteria
- fever
- dry skin
- green/yellow sputum
- unilateral breath sound issue (rales, diminished, absent, crackles)
CHF
- hypertension and left ventricular failure
- no fever
- pale
- diaphoretic
- moist skin
- hypertension
- bilateral breath sound issue (rales)
- dependent edema-increased with laying flat
what does CHF stand for?
congestive heart failure
pulmonary embolism
rapid onset of difficulty breathing and chest pain (especially high suspicion in the patient without a significant cardiac or respiratory history)
- “a blood clot that develops in a blood vessel in the body”
pulmonary embolism common in which patients?
- bedridden (chronically or after surgery)
- long flights
- history of deep vein thrombosis (DVT)
- female patient (teens - 40 years) on birth control
- history of smoking
signs of pulmonary embolism
- rapid onset of dyspnea
- cough
- pain
- anxiety
- hypertension
- tachypnea
- tachycardia
- crackles, wheezes, rhonch
treatment of pulmonary embolism
identification and rapid transport
simple pneumothorax
- presence of air in the pleural space
- could be caused spontaneously or by trauma
- breath sounds may be diminished or absent
- patient may be becoming dyspneic and restless
- tachypnea
tension pneumothorax
- accumulation of air in the pleural space that causes “tension” (obstruction)
- Jugular Vein Distention (JVD)
- hyper resonance on percussion
- subcutaneous emphysema
- patient will become hypotensive in late stages (obstructive shock)
albuterol
- beta-2 agonist
- bronchodilator (dilates the bronchioles in lower airways)
indications of albuterol
asthma, COPD, wheezing breath sounds
dosage of albuterol
2.5mg in 3mL of normal saline, nebulized
other facts about albuterol
- patients commonly will have rescue inhalers
- patients will likely have increased heart rate and “jitters” after administration
- medications must be breathed deeply to reach alveoli (ask patients to take deep breaths and hold as long as possible)
oxygen
- a medication
- never withhold oxygen from any patient (a patient in respiratory distress qualifies for high-flow oxygen)
- 1-15LPM, depending on device
- target SPO2 levels of 94-99% (especially in infants, suspected stroke and MI patients)
what does MI stand for?
myocardial infarction
dyspnea
“difficult or labored breathing”
tachypnea
“abnormally, rapid breathing”
pleural space
“the cavity that exists between the lungs and underneath the chest wall”
Jugular Vein Distention (JVD)
“large veins in the neck bulge or swell”
- “when blood can’t flow properly”
- “increase blood pressure”
subcutaneous emphysema
“condition where air or gas gets into the tissues under the skin”
hypotension
“medical condition that occurs when blood pressure is lower than normal”
obstructive shock
“something is obstructing blood from going into and out of your heart or great vessels”
hypertension
“high blood pressure”
tachycardia
“an abnormally rapid heart rate”
edema
“swelling caused by too much fluid trapped in body’s tissues”
diaphoretic
“excessive sweating”
unilateral breath sounds
“breath sounds that are absent or unequal on one side of the chest”
bilateral breath sounds
“equal breath sounds that come from both lungs”
intercostal retractions
“medical emergency that occurs when the muscles and skin between the ribs pull inward while breathing in”
ETCO2
“the amount of carbon dioxide released at the end of an exhaled breath”
bronchoconstriction
“condition that occurs when the airways in the lungs narrow, making it difficult to breathe”
emphysema (“pink puffer”)
“type of lung disease that causes breathlessness”
- “usually caused by cigarette smoking”
chronic bronchitis (“blue bloater”)
“long-term inflammation of the bronchi”
nonproductive cough
“cough that doesn’t produce mucus”
- a.k.a. “dry cough”
productive cough
“cough that produces mucus”
clubbing of fingers
“physical sign that causes the tips of fingers to enlarge and become rounder than normal”
