Airway

-a process in which molecules move from an area of higher concentration to an area of lower concentration 

upper airway functions: warm filter and humidify air 

the introduction to vomitus or other foreign material into the lungs 

 leaf shaped cartilaginous structure that helps separate the digestive system from the respiratory system. To help prevent food and liquid from entering th larynx during swallowing 

- lung tissue is covered with a thing, slippery outer membrane

 lines the inside of the thoracic cavity 

 thin, hollow tubes made of smooth muscle 

the physical act of moving air into and out of the lungs 

 the process of loading oxygen molecules onto hemoglobin molecules in the bloodstream 

 the actual exchange of oxygen and co2 in the alvoli as well as the tissues of the body 

• --the active, muscular part of breathing that draws air into the airway and lungs ---diaphragm and intercostal muscles contract 
• --when the diaphragm contracts, it moves down slightly and enlarges the thoracic cage from top to bottom and when the intercostal muscles contract, they lift the ribs up and out 

--voluntary muscle--> when taking a deep breath coughing or holding your breath ---> automatic ; during sleep and other times 

-term used to describe the amount of fas in air or dissolved in fluid, such as blood 

- “the volume of air that reaches the aveloi” determined by subtracting the amount of dead space air from the tidal volume 

  the amount of air ml that is moved in or out of the lungs during one breath 

 the portion of the tidal volume that doesn’t reach the alveoli and thus doesn’t participate in gas exchange. 

(minute volume) the amount of air moved through  the lungs in one minute minus the dead space~ calculated by subtracting the dead space from the tidal volume, then multiplying that number by the respiratory rate

• patient is breathing at a rate of 12 but the tidal volume is reduced(shallow) minute volume will decrease 
• patient is breathing at a rate of 12 and the tidal volume increase (deep breathing) minute volume will increase 

amount of air that can be forcibly expelled from the lungs after breathing deeply

the air that remains in the lungs after maximal expiration 

 doesn’t normal require muscular effort --passive process--diaphragm and intercostal muscles relax

=a dangerous condition in which the body tissues and cells do not have enough oxygen 

=a condition in which chronically low levels of oxygen in the blood stimulate the respiratory drive, seen in patients with chronic lung diseases.

=shortness of breath 

• adequate oxygenation is required for internal respiration to take place however it doesn’t guarantee internal respiration is taking place. you generally cannot oxygenate with out ventilation it is possible to ventilate with out oxygenation 
• ventilation with out adequate oxygenation occurs in clumbers who ascend too quickly to an altitude of lower atmoshperic pressure--at high alt the percentage of 02 remains the same but atmoshperic pressure make it difficult to adequately bring sufficeint amount of o2 into the body 

the biochemical processes that result in production of energy from nutrients within the cells 

respiration is the process of exchaning oxygen and co2 happens by diffusiotn 

pulmonary respiration--is the process of breathing fresh air into the respiratory system and exchaning o2 and co2 between the alveoli and the blood in the pulmonary capillaries 

• 21%02 
• 78%N 
• .3% co2 

a lipid proten substance that coats teh alveoli in the lungs, decreases alveolar surface tension, an keeps teh alveoli expanded, a low level in a premature infant contributes to respiratory distress syndrome

the exchang eof oxygen and co2 between the systemic curculatory system and the cells of teh body 

metabolsim that can proceed only with oxygen 

metabolism that take place in the absence of oxygen, the principle product i lactic acid 

monitor the levels of02 co2 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 bodys needs at any given time 

increased carbon dioxide level in the bloodstream 

bypassing of oxygen poor blood past nonfunctional alveoli to th eleft side of the heart 

a life threathing collection of air within the pleural space , the volume and pressure have both collasped the involved lung and caused a shift of the mediastinal structures to the opposite side 

• normal rate 12-20 
• a regular pattern of inhalation and exhalation 
• clear and equal lung sounds on both sides of the chest(bilateral) 
• regular and equal chest rise and rall 
• adequate depth or tidal volume 

devise with a one way valve and a face mask attached to a ventilation bag, when attached to a reserbior and connected to o2 delivers more that 90% supplamental oxygen 

• adult 12-20
• children 15-30
• infants 25-50

breathing that requires greater than normal effort, mau ne slower or faster than normal and usually requires the use of accessory muscles 

neck muscle chest pectoralis major and abs 

• resp rate fewer than 12 or more than 20 
• irr rythm 
• diminished absent or noise ausculated breath sounds 
• unequal chest expansion, resulting in reduced tidal colume 
• increaed effort of breathing 
• shallow depth 
• skin that is pale, cyanotic , coool or moist 
• skin pulling in aournd the ribs or aboice the clavicles during insirations 

skin pulling in around the ribs or aboce the clacivles during inspiration 

• occasional, gasping breaths that occur after the heart has stopped 
• **you will need to procide artifical ventilations and most likely chest compressions 

respirations are often seen in patients with stroke and patients with serious head injuries 

lack of spontaneous breathing

ineffective respirations tha may or may not have a identidiafiable pattern 

an assessment tool that measure oxygen sturation of hemoglobin in the capillary beds 

• hypovolemia 
• anemia 
• severe peripheral vasoconstriciton 
• time delay in detecting respiratory insufficeincy 
• nail polish 
• dirty fings 
• carbon monoxide--displaces o2 from the hemoglobin

•  relaxation of the tongue in an unresponsive patient 
• foreign objects 
• blood clots ,broken teeth following tramua 
• airway tissue swelling infection, allergic reaction 
• aspirated vomitus 

• a combination of two movements to open the airway by tilting the forehead back and lifting the chin
• **not used for trauma patients 

technique to open the airway by placing the fingers behind thae angle of the jaw and bringing the jaw forward

used for patients who may have a cervical injury 

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

• unresponsive patients without a gag reflex 
• any apneic patient being ventilated with a bag mask device 

• conscious patients 
• any patient who has an intact gag reflex 

 protective relex mechanism that prevents food and other particles from entering teh airway. 

used withan unresponsive patient or a patient with an altered elvel of consciousness who has an intact gag relex and is not able to maintain hsi or her airway spontaneuously 

• semiconscious or unconscious patients with an intact gag relex 
• patients who otherwise will not tolerate an orpharyngeal airway 

• severe head injury with blood draining from teh nose 
• history  of fractured nose s

a hollow, cylindrical device that is used to remove fluids from the patients airway 

a tonsil tip catheter is the best kind of catheter for suctioning the oropharynx in adults 

opening through the skin that goes into an organ or other stucture 

tips with a contour  french or whistle tip

a side laying postiion used to maintain a clear airway in unconscious patients without injuries who are breathing adequately 

 

 a system established for portable cylinders to ensure taht a regulator is not connected to a cylinder containing the wrong type of gas 

2,000psi 

• a combination mask and resercior bag system that is the prederred way to give oxygen in the prehoptial settering 
• delivers up to 90 percent inspired oxygen and prevents inhaling the exhaled gas

showing signs of hypoxia 

• an oxigen delivery device in which oxygen flows through two small, tuvelike prongs that fit into the patients nostrils
• delivers 24% to 44% supplemtntal oxygen
• 1-6L
• can dry out the nose( consider use of humidifier) 

• 24-40 % 
• the use of its fine adjustment capaabilities in the long term maagement of physiologicall stabel patients 

masks designed to cover the tracheostomy hole 

• mouth to mask with one way valve 
• two person bag mask device with reservior and supplemental oxygen
• manually triggered ventilation device 
• one person bag mask device with oxygen reservior and sup o2 

• improve the overall oxugenation and ventialatory status of patiens 
• pat are no longer able to maintain adequate oxygen levels for the body and need assistance to prevent further hypoxia 

• adult one breath per  5 to 6 sec 
• child one breath per 3 to 5 sec 
• infant one breath 3 to 5 sec 

a protective item such as a pocket mask with a valve that limtis exposure to a patients body fluids 

• oxygen flow rate at 15 l per min and a adequate seal can deliver nearly 100% o2
• provides less tidal volume than mouth to mask ventilation, but it delivers a much higher concentration of oxygen. 
• most common method 

a condition in which air fills the stomach  often as a result of high colume and pressure during artifical ventialtion 

• a fixed flow rate ventilation device that delivers a breath every time its button is pushed, also referred to as a flow resticted oxygen powered ventilation device
• device shouldnt' be used on patients with copd or suspected cervial spine or chest injureis 

• the ability of the alveoli to expand when air i drawn in during inhalation, poor lung compliance is the inabliltiy of the alveoli to fully expand during inhilation
• barotrauma is common complication assc with manually triggered ventilation needs to asses for full chest recoil ATV

a method of ventilation used primarily in the treatment of critically ill patients with respiratory distress, can prevent the need for endotracheal intubation 

increases pressure in the lungs opens collapsed alveoli, pushes more oxygen across teh alveolar membrane and forces interstitial fluid back into the pulmonary circulation 

• patient must be alert and able to follow commands 
• patient is displaying obcious sighns of moderate to severe respiratory distress from an underlying pathology, such as pulmonary edema or obstuctive pulmonary disease
•  patient is breathing rapidly such that it affects overall minute volume 

• patient who is in respiratory arrest
• signs and symptoms of a pneumothrorax or chest trauma  patient who has a tracheostomy 
• active gastrointestinal bleeding or vomiting 
• patient is unable to follow verbal commands 

surgical opening in the trachea 

• the production of whistling sounds during respirations 
• indicative of a mild lower airway obsturction 
• as long as teh patient can breath cough forcefull or talk you should not interfere with the patients efforts to expel the foregn object 

• weak, ineffective cough and may have increased difficutly breathing (stridor--a high pitched noise heard primarily on inspiration ) and cyanosis 
• an indication of a mild upper airway obstuction