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prehospital care theory > term test 2 > Flashcards

term test 2 Flashcards

1
Q

order in which you check a patient with airway problem

A
  1. primary survey
  2. airway
  3. breathing
  4. circulation
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2
Q

what is the first and most important step in achieving oxygenation and ventilation

A

airway management

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3
Q

3 important things to check for when assessing the airway

A
  1. patent (clear)
  2. protected
  3. functional
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4
Q

patency

A

the ability of a person to breathe, with airflow passing to and from the respiratory system through the oral and nasal passages

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5
Q

3 causes for a failure of patency

A
  1. trauma - facial fracture, tracheal laceration
  2. allergy - anaphylaxis, angioedema of the tongue or pharynx
  3. disease process - prevents or impeded a clear trajectory for air to travel
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6
Q

paranasal sinuses

A

hollow spaces filled with air, located around the nose inside the skull

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7
Q

nasal cavity

A

functions to humidify, warm, filter and act as a conduit for inspired air

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8
Q

nasopharynx

A

the most superior portion of the pharynx and is bounded superiorly by the skull base and interiorly by the soft palate. it connects the nasal cavity to the oropharynx

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9
Q

hard palate

A

separates the oral cavity from the nasal cavity and forms the floor of the nasal cavity and root of the oral cavity

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10
Q

soft palate

A

the soft tissue constituting the back of the roof of the mouth

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11
Q

oropharynx

A

middle part of the pharynx (throat) behind the mouth

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12
Q

tonsil

A

lymph nodes in the back of the mouth and top of the throat and helps filter out bacteria and other germs to prevent infection in the body

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13
Q

tongue

A

muscular organ and is formed by complex intristic and extrinsic muscles

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14
Q

intristic

A

change in shape of the tongue

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15
Q

extrinsic

A

in charge of moving the tongue in different directions

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16
Q

laryngopharynx

A

crucial connection point through which food, water and air pass

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17
Q

epiglottis

A

small, leaf-shaped sheet of elastic cartilage that protects your larynx (voice box) and helps you swallow

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18
Q

vocal cords

A

2 bands of the smooth muscle tissue found in the larynx

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19
Q

esophagus

A

tubular, elongated organ of the digestive system which connects the pharynx to the stomach and is the organ that food travels through to reach the stomach for further digestion

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20
Q

trachea

A

long, U shaped tube that connects your larynx to your lungs

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21
Q

nares

A

nostrils

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22
Q

mandible

A

largest bone in the human skill and is the lower jaw

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23
Q

hyoid bone

A

small, U shaped (horse shaped) solitary bone that is situated in the midline of the neck

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24
Q

thyroid cartilage

A

largest cartilage of the larynx and is composed of hyaline cartilage

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24
Q

cricoid cartilage

A

serves to maintain airway patency and functions in the opening and closing of the vocal cords for sound protection

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25
Q

thyroid gland

A

produces hormones that regulate the body’s metabolic rate, growth and development and plays a role in controlling heart, muscle and digestive function, brain development

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26
Q

components of the upper respiratory tract

A
  1. nose
  2. mouth
  3. sinuses
  4. pharynx
  5. larynx
27
Q

components of the lower respiratory tract

A
  1. trachea
  2. bronchial tubes
  3. lungs
28
Q

airway obstruction

A

a blockage in any part of the airway

29
Q

2 levels of airway obstruction

A

partial or complete (total) obstruction
**which prevents air from getting into your lungs

30
Q

what are possible causes of an obstruction in an airway

A
  1. blood
  2. vomit
  3. swelling of the airway
  4. foreign body
  5. laryngeal spasm
31
Q

example of partial vs complete obstruction - choking

A

partial
- can still breathe
- may be coughing
- may be talking or mumbling
- watch and encourage them to cough

complete
- hands on neck
- no sounds or noises
- cyanosis (lip area goes blue)
- complete blockage of airway
- needs help immediately

32
Q

airway compromise

A

occurs whenever a traumatic or medical event causes a disruption in the natural and unimpeded flow of air through the airway structures

33
Q

what is the top priority when a airway becomes compromised

A

airway management

34
Q

levels of responsiveness or LOC

A

A - alert
V - verbal response to stimuli
P - pain response to stimuli
U - unresponsive

35
Q

7 medical ways a airway can be compromised

A
  1. anaphylaxis / allergy
  2. COPD
  3. vomiting
  4. asthma / respiratory infection
  5. loss of consciousness
  6. seizure
  7. overdose / intoxication
36
Q

5 trauma ways a airway can be compromised

A
  1. hanging
  2. direct trauma
  3. head injury
  4. tongue bite
  5. burns
37
Q

overdose, vomiting, seizures + unconscious = ?

A

a compromised airway

38
Q

seizures

A

electrical impulses all signalling and firing at once

39
Q

post ictal phase of a seizure

A

the ictal phase of a seizure is often associated with involuntary movements or a decreased level of awareness (altered state of mind)

40
Q

examples of things that could cause airway swelling

A
  1. fire or contact with flames
  2. hot gases
  3. liquids (chemical burns)
    ** if the outside is damaged there is a greater concern for the impact on the inside
41
Q

airway swelling

A

can produce life-threatening upper airway swelling = limited ability to move air

42
Q

5 things to look for during an airway assessment

A
  1. positioning
  2. fluids and secretions
  3. swelling
  4. injury
  5. adventitious sounds
43
Q

positioning

A

loss of consciousness produces loss of muscle
- airway becomes more easily mispositioned
- easily fixed and repositioned
- patients with high BMI especially at risk

44
Q

fluid and secretions

A

visualize the oropharynx in the less responsive patient
- vomit
- blood
- saliva
- mucus

44
Q

adventitious sounds

A

turbulent airflow noises
- snoring / stutter
- stridor

45
Q

stridor

A

high pitched, whistling sounds caused by the narrowing of the upper airway

46
Q

what is adventitious sounds caused by

A
  • poor position
  • loss of muscle tone (tongue)
  • airway edema
  • presence of secretions
47
Q

what to look for in a responsive patient with fluid secretions

A
  • observe for airway patency through speech
  • visualize the head and neck and inside the mouth
48
Q

what to look for in a unresponsive patient with fluid secretions

A
  • visualize the head and neck for positioning
  • open the mouth and visualize the oropharynx for fluids secretions and foreign objects (use flashlight)
  • listen for adventitious sounds
49
Q

4 types of manual positioning

A
  1. head, tilt, chin lift
  2. jaw thrust
  3. sniffing of sipping
  4. ear to sternal notch (E2SN)
50
Q

Jaw thrust

A
  • recommended where there is a risk of cervical spine injury
  • brings the mandible forward and relieves the obstruction by the soft palate and epiglottis
  • lifts the tongue off the oropharynx
51
Q

sniffing position

A
  • involves neck flexion (head elevation)
  • done so by putting a pillow or blanket under the head and then extending the head at the atlas and occipital bone
52
Q

ear to sternal notch position technique

A
  • PREFERRED airway management position (without suspected spinal injury)
  • use with decreased or unresponsive patient
  • position blankets or pillows under the top of the shoulder and under the occiput (back of the head)
    called ramping in obese patients
  • face plane is parallel with ceiling
  • ears should be level with the chest (sternal notch)
53
Q

2 types of suctioning

A
  1. manual
  2. automated suction device
54
Q

V-Vac suction technique

A
  • insert the device into the oropharynx as far as you can see and pull the handle repeatedly to create a vacuum and suction until the airway is clear
  • mandated by the MOH (although it SUCKS at SUCKING)
55
Q

Portable (automated) suction

A
  • small, portable, battery-operated suction units
  • variable vacuum pressures
56
Q

4 portable suction techniques

A
  1. turn the unit on
  2. select the appropriate suction pressure (adult = 300-550mmHg)
  3. select a suction catheter
  4. Insert the catheter into oropharynx and suction until the airway is clear
57
Q

when suctioning the mouth what is the maximum suction time

A

10-15 seconds max and then check again and reassess

58
Q

oropharyngeal (OPA) airway

A
  • different colours = different size
  • decreased level of consciousness
  • curved plastic device
59
Q

what is the OPA

A

designed to be used in unconscious patients requiring airway support and should only be inserted in those patients who have absent laryngeal and glossopharyngeal reflexes

60
Q

indications and uses of the OPA

A

indications
- unresponsive patients with no gag reflex

uses
- lift the tongue off the oropharynx to create patency

61
Q

techniques for insertion of an OPA

A
  1. hard palate
  2. soft palate
  3. rotate 180 degrees
  4. rest at the teeth
62
Q

nasopharyngeal airway “trumpets”

A
  • designed to relieve soft tissue upper airway obstruction in a patient requiring airway support
63
Q

indications of a NPA

A
  • decreased level of responsiveness
  • requires airway support, but has intact gag reflex

prehospital care theory (5 decks)

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