Ventilation Flashcards
What are the primary reasons for inadequate chest ventilation?
A) inadequate respiratory effort,
B) airway obstruction
or a combination of these two
What is the appropriate intervention if a pt is not breathing at all (apneic)?
then the physician must immediately perform a simple maneuver such as a chin lift to open the airway and commence ventilation of the chest with a bag-mask device.
If the patient is making respiratory effort but is not adequately ventilating his/her chest because of airway obstruction the physician must….
Determine the cause and take immediate measures to alleviate the obstruction.
1) In an unconscious patient, the cause of the obstruction will often be prolapse of the tongue into the posterior pharynx due to loss of tone in the submandibular muscles. This problem can be quickly corrected using a simple maneuver such as a head tilt-chin lift or jaw thrust and this may be all that is needed to open the airway and allow adequate chest ventilation.
2) If the physician encounters noisy or “gurgling” respirations at this point, the upper airway should be suctioned for vomitus and excess secretions.
What is the function of oropharyngeal or nasopharyngeal airways?
Make it easier to maintain an open airway. Both of these devices prevent the tongue from occluding the airway and thereby provide an open conduit for air to pass.
It is important to note that these two airway devices, unlike a cuffed endotracheal, tube will not protect the trachea from aspiration of secretions or stomach contents. If a patient is unable to protect their own airway, they should have an endotracheal tube inserted as soon as possible by someone who is has specific training and expertise in that skill.
What are potential complications of chest tube insertion?
bleeding, air leaks, and infection, and control risk factors
Left untreated, a tension pneumothorax can cause severe respiratory distress and cardiovascular collapse. Symptoms include…
severe dyspnea or chest pain that deteriorates to the absence of breath sounds on the affected side,
tracheal shift to the unaffected side, and
hypotension or tachycardia.
Immediately check the chest tube and all tubing for occlusions, kinks, clots, and clamps. Notify the healthcare provider, prepare for another chest tube insertion, and bring the code cart to the bedside.
Describe the process of Chest Tube removal
you’ll need a suture removal kit, a petroleum gauze dressing, dressing sponges, and occlusive tape.
Although the procedure can be briefly painful for the patient, premedication is limited because he must be able to participate actively in deep breathing exercises after removal.
Instruct the patient that the tube will be removed after a deep breath during the exhalation phase. The healthcare provider will remove the tube in one fluid motion and immediately apply an occlusive dressing. A chest X-ray will be ordered to confirm lung expansion.
You’ll continue to monitor the patient closely for the next 2 hours or more and report any signs of respiratory distress or decreased oxygenation.
What are the various thoracic surgeries?
Pneumonectomy: removal of an entire lung
Lobectomy: Removal of a lung lobe
Segmentectomy (segmental resection): removal of a bronchopulmonary segment
Wedge resection: removal of a small, well-defined lesion without regard for intersegmental planes, performed for lung biopsy and removal of nodules
broncholplastic or sleeve resection: only one lobular brochus together with a part of the R or L bronchus are removed, distal brochnus is reattached to proximal bronchus or trach.
Lung volume reduction: removal of 20-30% of lung tissue
video thoracoscopy:
