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EMRG 1242- EXAM PREP > Week 8- Oxygenation and Ventilation > Flashcards

Week 8- Oxygenation and Ventilation Flashcards

1
Q

Administer high concentration O2 for pt’s who have….

A

confirmed/ suspected carbon monoxide/ cyanide toxicity/ noxious gas exposure
upper airway burns
scuba diving related disorders
ongoing cardiopulmonary arrest
complete airway obstruction
sick cell anemia with suspected vaso-occlusive crisis

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2
Q

How do we oxygenate a pt with COPD?

A

titrate oxygen administration
achieve O2 saturation between 88-92 %
Reassess vitals every 10 mins
Increase by increments of 2Lpm above starting level approx every 2-3 mins

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3
Q

What is oxygen saturation?

A

the fraction of o2 saturated hemoglobin relative to the TOTAL hemoglobin in the blood
normal should be 97-100%
SpO2 %

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4
Q

What is COPD?

A

Chronic Obstructive Pulmonary Disease
- blocked airway causes inflammation=chronic bronchitis
- damage to air sacs makes gas exchange DIFFICULT
- smokers, long term chemical exposure etc.
These pt’s are CO2 retainers, we titrate because there is potential to knock out their hypoxic drive

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5
Q

What are the 2 types of oxygen tanks?

A

D tank- carried in the medics bag, holds 425L of O2
M tank- in the ambulance, holds 3450L of O2

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6
Q

What is the regulator?

A

Attached to the top of the cylinder
Reduces and elevated PSI
Attaches to the yolk!
Has a flowmeter to regulate O2 amount to the delivered

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7
Q

What is the PISS?

A

Pin Index Safety System
- ensures you are attached to the o2 tank
- attached directly to the tank
- three pin holes

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8
Q

What is the portable flowmeter?

A

Controls the amount of oxygen being delivered
Connected to the regulator

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9
Q

What is the safe residual pressure according to the MOH EMS Standards?

A

500 psi

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10
Q

How do you calculate oxygen tank life?

A

(tank pressure in psi - safe residual) x factor ÷ Lpm
= time till cylinder is empty

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11
Q

What is the standard tank conversion factor for an M cylinder?

A

1.56

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12
Q

What is the standard tank conversion factor for an D cylinder?

A

0.16

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13
Q

When do we change tanks?

A

500psi left

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14
Q

Who are the supplemental devices used for?

A

Pt’s with spontaneous respirations

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15
Q

Who are ventilation devices used for?

A

Pt’s who cannot breathe on their own
VENTILATION
- BVM
- CPAP

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16
Q

What is FiO2?

A

Fraction of INSPIRED oxygen

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17
Q

What is the breathing room air FiO2?

A

~21%

18
Q

What is the formula for FiO2 calculation?

A

(L/min x 4 ) + 21 = fraction of inspired o2

19
Q

What influences FiO2?

A

Breathing rate and depth

20
Q

What are the low flow devices?

A

Cannulas
Simple face masks (ped)
Nebulizer mask

21
Q

What is the low concentration %?

A

21%-50%

22
Q

When do you choose a Nasal Cannula?

A

pt requires low concentration O2
NO dyspnea
NOT apenic (resp. arrest)
Able to breath through nose
Pt that cannot keep face mask on (ex. vomitting)
Pt with COPD and exhibiting complaints of SOB w no altered LOA
Often a more stable pt

23
Q

What does a nasal cannula run at?

A

2-6 Lpm

24
Q

When to use Simple Oxygen mask?

A

minor/mild complaints
lower concentration O2
runs at 6-10Lpm
not common, often in pediatric size

25
Q

When to use the Nebulizer mask and what do you run it at?

A

needed to deliver medication (ventolin)
called nebulized treatment
runs at 4-6Lpm

26
Q

What are the high flow devices?

A

NRB
BVM
FLOW MAX
CPAP

27
Q

What is the % for high concentration O2 devices?

A

50-100%

28
Q

When to chose a Non Rebreather?

A

pt requires HIGH concentration O2
pt can maintain their own airway
pt with c/o SOB, evidence of resp. distress
pt with low SP02

29
Q

What does an NRB run at?

A

12-15Lpm
90-100 o2 delivery

30
Q

When to chose a FLOMAX?

A

Covid
Resp illness
Fever
Anything infectious
**need to administer medication (attaches to nebulizer cup)

31
Q

What is a Flowmax run at?

A

12-15Lpm

32
Q

Respiration Is the process of breathing that involves ……

A

both ventilation and oxygenation

33
Q

Ventilation is the molecular exchange of…..

and involves movement of air…..

A

gases in the body

in and out of the lungs

34
Q

Oxygenation is the molecular absorbance of oxygen that involves the…

A

diffusion of oxygen molecules from environmental air into the blood stream

35
Q

Bag Valve Mask: what does it run at?

A

runs at 12-15Lpm
100% O2

36
Q

How to BVM:

A

create a tight SEAL (C & E)
ventilate at 10-12 breaths/min
timing: squeeze BVM during inhalation phase
Communication with pt

37
Q

When to use the BVM:

A

Respiratory rate TOO low: breathing lower than 8 VENTILATE or < 12 bpm and hypo-perfusion is present

Respiratory rate TOO high: > 28 bpm

38
Q

How to manage airway:

A
  • OPEN using manual airway techniques like head tilt-chin lift / modified jaw thrust OR to get a better opening use an OPA or NPA
  • CLEAR the airway using suctioning devices
39
Q

When do we insert an OPA?

A

No gag reflex (eyelash test)
Unconscious
Decreased LOC
Hypoventilation

40
Q

When do we insert an NPA?

A

Pt with GAG reflex
Contraindications: basul skull #
Trismus
Pt has to be over 5 yrs old
LUB it up!

41
Q

When preparing to insert BLS airway devices…

A
  1. Open airway (assess if suctioning needed)
  2. Measure device needed
  3. Insert with caution
42
Q

How to measure an OPA?

A

Corner of the to the jaw

EMRG 1242- EXAM PREP (10 decks)

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