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aerobic metabolism
Metabolism that can proceed only in the presence of oxygen.
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agonal respirations
Slow, shallow, irregular respirations or occasional gasping breaths; sometimes seen in dying patients.
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alveolar ventilation
The volume of air that reaches the alveoli. It is determined by subtracting the amount of dead space air from the tidal volume.
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American Standard System
A safety system for large oxygen cylinders, designed to prevent the accidental attachment of a regulator to a cylinder containing the wrong type of gas.
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anaerobic metabolism
The metabolism that takes place in the absence of oxygen; the principle product is lactic acid.
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apnea
Absence of spontaneous breathing.
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aspiration
In the context of airway, the introduction of vomitus or other foreign material into the lungs.
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ataxic respirations
Irregular, ineffective respirations that may or may not have an identifiable pattern.
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automatic transport ventilator (ATV)
A ventilation device attached to a control box that allows the variables of ventilation to be set. It frees the EMT to perform other tasks while the patient is being ventilated.
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bag-mask device
A device with a one-way valve and a face mask attached to a ventilation bag; when attached to a reservoir and connected to oxygen, it delivers more than 90% supplemental oxygen.
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barrier device
A protective item, such as a pocket mask with a valve, that limits exposure to a patient's body fluids.
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carina
Point at which the trachea bifurcates (divides) into the left and right main stem bronchi.
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chemoreceptors
Monitor the levels of O2, CO, and the pH of the cerebrospinal fluid and then provide feedback to the respiratory centers to modify the rate and depth of breathing based on the body's needs at any given time.
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compliance
The ability of the alveoli to expand when air is drawn in during inhalation.
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continuous positive airway pressure (CPAP)
A method of ventilation used primarily in the treatment of critically ill patients with respiratory distress; can prevent the need for endotracheal intubation.
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cricoid pressure
Pressure on the cricoid cartilage; applied to occlude the esophagus to inhibit gastric distention and regurgitation of vomitus in the unconscious patient.
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dead space
The portion of the tidal volume that does not reach the alveoli and thus does not participate in gas exchange.
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diffusion
A process in which molecules move from an area of higher concentration to an area of lower concentration.
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dyspnea
Shortness of breath or difficulty breathing.
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exhalation
The passive part of the breathing process in which the diaphragm and the intercostal muscles relax, forcing air out of the lungs.
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external respiration
The exchange of gases between the lungs and the blood cells in the pulmonary capillaries; also called pulmonary respiration.
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gag reflex
A normal reflex mechanism that causes retching; activated by touching the soft palate or the back of the throat.
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gastric distention
A condition in which air fills the stomach, often as a result of high volume and pressure during artificial ventilation.
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glottis
The space in between the vocal cords that is the narrowest portion of the adult's airway; also called the glottic opening.
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good air exchange
A term used to distinguish the degree of distress in a patient with a mild airway obstruction. With good air exchange, the patient is still conscious and able to cough forcefully, although wheezing may be heard.
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head tilt–chin lift maneuver
A combination of two movements to open the airway by tilting the forehead back and lifting the chin; not used for trauma patients.
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hypercarbia
Increased carbon dioxide level in the bloodstream.
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hypoxia
A dangerous condition in which the body tissues and cells do not have enough oxygen.
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hypoxic drive
A "backup system" to control respiration; senses drops in the oxygen level in the blood.
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inhalation
Breathing into the lungs; a medication delivery route.
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internal respiration
The exchange of gases between the blood cells and the tissues.
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intrapulmonary shunting
Bypassing of oxygen-poor blood past nonfunctional alveoli to the left side of the heart.
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jaw-thrust maneuver
Technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used for patients who may have a cervical spine injury.
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labored breathing
Breathing that requires greater than normal effort; may be slower or faster than normal and usually requires the use of accessory muscles.
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larynx
A complex structure formed by many independent cartilaginous structures that all work together; where the upper airway ends and the lower airway begins; also called the voice box.
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manually triggered ventilation device
A fixed flow/rate ventilation device that delivers a breath every time its button is pushed; also referred to as a flow-restricted, oxygen-powered ventilation device.
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mediastinum
Space within the chest that contains the heart, major blood vessels, vagus nerve, trachea, major bronchi, and esophagus; located between the two lungs.
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metabolism (cellular respiration)
The biochemical processes that result in production of energy from nutrients within the cells.
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mild airway obstruction
Occurs when a foreign body partially obstructs the patient's airway. The patient is able to move adequate amounts of air, but also experiences some degree of respiratory distress.
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minute ventilation
The volume of air moved through the lungs in 1 minute minus the dead space; calculated by multiplying tidal volume (minus dead space) and respiratory rate; also referred to as minute volume.
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nasal cannula
An oxygen-delivery device in which oxygen flows through two small, tubelike prongs that fit into the patient's nostrils; delivers 24% to 44% supplemental oxygen, depending on the flow rate.
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nasopharyngeal (nasal) airway
Airway adjunct inserted into the nostril of an unresponsive patient, or a patient with an altered level of consciousness who is unable to maintain airway patency independently.
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nasopharynx
The nasal cavity; formed by the union of facial bones and protects the respiratory tract from contaminants.
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nonrebreathing mask
A combination mask and reservoir bag system that is the preferred way to give oxygen in the prehospital setting; delivers up to 90% inspired oxygen and prevents inhaling the exhaled gases (carbon dioxide).
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oropharyngeal (oral) airway
Airway adjunct inserted into the mouth of an unresponsive patient to keep the tongue from blocking the upper airway and to facilitate suctioning the airway, if necessary.
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oropharynx
Forms the posterior portion of the oral cavity, which is bordered superiorly by the hard and soft palates, laterally by the cheeks, and inferiorly by the tongue.
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oxygenation
The process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs.
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parietal pleura
Thin membrane that lines the chest cavity.
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partial pressure
The term used to describe the amount of gas in air or dissolved in fluid, such as blood.
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patent
Open, clear of obstruction.
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phrenic nerve
Nerve that innervates the diaphragm; necessary for adequate breathing to occur.
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pin-indexing system
A system established for portable cylinders to ensure that a regulator is not connected to a cylinder containing the wrong type of gas.
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pneumothorax
A partial or complete accumulation of air in the pleural space.
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poor air exchange
A term used to describe the degree of distress in a patient with a mild airway obstruction. With poor air exchange, the patient often has a weak, ineffective cough, increased difficulty breathing, or possible cyanosis and may produce a high-pitched noise during inhalation (stridor).
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positive end-expiratory pressure (PEEP)
Mechanical maintenance of pressure in the airway at the end of expiration to increase the volume of gas remaining in the lungs.
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pulse oximetry
An assessment tool that measures oxygen saturation of hemoglobin in the capillary beds.
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residual volume
The air that remains in the lungs after maximal expiration.
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respiration
The process of exchanging oxygen and carbon dioxide.
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retractions
Movements in which the skin pulls in around the ribs during inspiration.
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Sellick maneuver
A technique that is used with intubation in which pressure is applied on either side of the cricoid cartilage to prevent gastric distention and aspiration and allow better visualization of vocal cords; also called cricoid pressure.
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severe airway obstruction
Occurs when a foreign body completely obstructs the patient's airway. Patients cannot breathe, talk, or cough.
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stoma
An opening through the skin and into an organ or other structure; a stoma in the neck connects the trachea directly to the skin.
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stridor
A high-pitched noise heard primarily on inspiration.
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suction catheter
A hollow, cylindrical device used to remove fluid from the patient's airway.
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surfactant
A liquid protein substance that coats the alveoli in the lungs, decreases alveolar surface tension, and keeps the alveoli expanded; a low level in a premature infant contributes to respiratory distress syndrome.
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tension pneumothorax
A life-threatening collection of air within the pleural space; the volume and pressure have both collapsed the involved lung and caused a shift of the mediastinal structures to the opposite side.
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tidal volume
The amount of air (in milliliters) that is moved in or out of the lungs during one breath.
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tonsil tips
Large, semirigid suction tips recommended for suctioning the pharynx; also called Yankauer tips.
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ventilation
Exchange of air between the lungs and the environment, spontaneously by the patient or with assistance from another person, such as an EMT.
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visceral pleura
Thin membrane that covers the lungs.
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vital capacity
The amount of air that can be forcibly expelled from the lungs after breathing in as deeply as possible.
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vocal cords
Thin white bands of tough muscular tissue that are lateral borders of the glottis and serve as the primary center for speech production.
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