when oxygen doesnt get to the brain, it can begin to die with in __ to __ minutes
4-6 minutes
inhalation is when oxygen moves from the _____ to the ____
atmosphere to the lungs
process in which the oxygen crosses the alveolar and attaches to the hemoglobin
diffusion
____ cells carry hemoglobin
red blood cells
carbon leaves the body thru ____
exhalation
process of exchanging air between the lungs and the environment
ventilation
Anatomy of the Upper Airway:
these structures make up the _____
-nose
-mouth
-jaw
-oral cavity
-pharynx
-larynx
upper airway
Anatomy of the Upper Airway:
main functions of the upper airway is to ____,____ and ____ the air as it enters the body
warms,filters and humidify
Anatomy of the Upper Airway:
nasopharynx, oropharynx and laryngopharynx make up the _____
pharynx
Anatomy of the Upper Airway:nasopharynx
lined with ___ ____ ____ that filters out dust and small particles
ciliated mucous membrane
Anatomy of the Upper Airway: oropharynx
contains the _______ which helps prevent food and liquid from entering the larynx
epiglottis
Anatomy of the Upper Airway:larynx
form by many independents ____ structures
cartilaginous
Anatomy of the Upper Airway:larynx
divides the ____ and ____ airways
upper
lower
Anatomy of the Upper Airway:
known as the adams apple
thyroid cartilage
Anatomy of the Upper Airway:
forms the lowest portion of the larynx
cricoid cartilage
Anatomy of the Upper Airway:
narrowest part of an adults airway
glottis
Anatomy of the lower Airway:
function of the lower airway is to deliver oxygen to ____
the alveoli
Anatomy of the lower Airway: trachea
conduit for air entry in to the
lungs
Anatomy of the lower Airway: trachea
located in the ____ cavity
thoracic
Anatomy of the lower Airway:
bronchioles are made up of ____ muscle
-dialates and contract as oxygen passes through them
smooth muscle
Anatomy of the lower Airway:
bronchioles connect to the smaller _____
alveoli
Anatomy of the lower Airway:
oxygen and carbon are exchanged in the
alveoli
Anatomy of the lower Airway:
alveoli are surrounded by ______
pulmonary capillaries
Anatomy of the lower Airway:
the ___ is the area between the lungs which contain
-heart
-great vessels
-trachea
-major bronchi
mediastinum
Anatomy of the lower Airway:
phrenic nerve is located in the thorax and allows the ___ to contract, necessary for breathing
diaphragm
ventilation:
not all all inspired air reaches the ____
alveoli
ventilation:
average tidal volume is ____mL
500
ventilation:
amount of air that is moved into or out of the lung in a single breath
tidal volume
ventilation:
amount of air that doesnt reach the alveoli
dead space
ventilation:
failure to meet bodys needs for oxygen maye result in ___
hypoxia
ventilation:
COPD patients always have higher levels of
carbon dioxide
ventilation:
the drive to breath is base on the bodies ____
Ph level
ventilation:
tissues that are more ____ get more oxygen from RBC
acidic
ventilation:
tissues that are more ____ get less oxygen from RBC
alkalitine
what percent of air in nitrogen
78%
what percent of air is oxygen
21%
ventilation:
inhaltion is a ____ process
active
ventilation:
exhalation is a _____ process
passive
ventilation:
inhaling creates a ____ pressure
negative
ventilation:
exhaling creates a ____ pressure
positive
oxygenation:
process of loading oxygen molecules into the hemoglobin
oxygenation
respiration:
____ is the exchange of oxygen and carbon dioxide in the lung
external respiration
respiration:
_____ exchange of oxygen and carbon dioxide between tissues and the circulatory system
internal respiration
respiration:
cardiac irritability occurs how many mins are no oxygen
0-1 mins
respiration:
brain damage is not likely after how many mins are no oxygen
0-4mins
respiration:
brain damage is possible after how many mins are no oxygen
4-6mins
respiration:
brain damage is very likely after how many mins are no oxygen
6-10mins
respiration:
irreversible brain damage occurs after how many mins are no oxygen
10+mins
respiration:
when adequate amount of oxygen is in the body, cells convert glucose into energy thru what kind of metabolism
aerobic metabolism
respiration:
when insufficient oxygen is in the body, cells run off of what metabolism
anaerobic metabolism
which receptors monitor levels of:
-oxygen
-carbon dioxide
-hydrogen levels
-pH of cerebrospinal fluid
chemoreceptors
ventilation/perfusion mismatch:
ventilation and perfusion must be ____
matched
ventilation/perfusion mismatch:
a failure to match _____ and ____ is the cause of most abnormalities of oxygen and carbon dioxide exchange
ventilation and perfusion
ventilation/perfusion mismatch:
when there is a mismatch ____ ____ is not able to diffuse from blood to lungs
carbon dioxide
-results in carbon dioxide filled cells recirculating leading hypoxemia
____ respirations have an irregular or unidentifiable pattern and may follow serious head injury
ataxic
______ respirations are deep,rapid, commonly seen in patients with metabolic acidosis
kussmaul
patients with ______ breathing need to treated immidiately
inadequate
pulse oximeter:
what does a pulse oximeter measure?
oxygen saturation levels
pulse oximeter:
spo2 should be ___% to ___%while breathing normal room air
98%- 100%
pulse oximeter:
although no normal values exsist, an spo2 of less than ____% in a nonsmoker can indicate hypoemia
96%
pulse oximeter:
how long does it take for pulse oximeter to reflect changes
60secs
opening the airway:
adequate breathing means you also have an adequate airway
true/false
false
opening the airway:
most effective position for opening the airway is the ______ position
supine
opening the airway:
if patient is found in the prone position you should reposition the patient in the supine position by _____
log roll
-move the patient in a way so that the whole body, neck and head move as a unit
opening the airway:
the most common airway obstruction is the ____ in unconscious patients
tongue
opening the mouth:
for patients who have not sustained spinal trauma you can use the _____ ____ ___ ____to open the airway
head tilt chin lift
opening the mouth:
patients with suspected spinal injury you should use the ___ ___ to open the airway
jaw thrust
opening the mouth:
chest movement alone doesnt indicate that the breathing is adequate
true/false
true
suctioning:
if you hear gurgling, the patient needs ____
suctioning
suctioning:
if the airway is not clear, you will force secretions and fluids into the _____
lungs
suctioning:
A ____ ____ unit must provide enough vacuum pressure and flow to allow you to suction the mouth and nose effectively
portable suctioning unit
suctioning:
A __ ___ unit should generate airflow of more than 40L/min and a vacuum of more than ____mm Hg when the tubing is clamped
fixed suctioning
300
suctioning:
____ and ___ should be fitted with the following
-Wide-bore, thick-walled, nonkinking tubing
-Plastic, rigid pharyngeal suction tips, called tonsil tips or Yankauer tips
-Nonrigid plastic catheters, called French or whistle-tip catheters
-A nonbreakable, disposable collection bottle
-Water supply for rinsing the tips
portable and fixed
suctioning:
a hollow,cylindrical device used to remove fluid from the airway
suction catheter
suctioning:
best kind of catheter for children and infants is
tonsil tip catheter
-large diameter tips are rigid and do not collapse
suctioning:
soft plastic, non rigid catheters are called
french tip/ whistle tip
used when
-patient has a stoma
-patient with clenched teeth
-suctioning the nose is nexcessary
suctioning:
before inserting a catheter ensure proper ____
size
suctioning:
never suction more than ___ secs on adults
15secs
suctioning:
never suction more than ___ secs for children
10secs
suctioning:
never suction more than ___ secs for infants
5secs
suctioning:
repeat suctioning only after the patient has been adequately ____ and ____
ventilated and reoxygenated
suctioning:
some secretions are to large to be suctions, in these case you should_____
log roll the patient enough to clear the mouth
suctioning:
if a patient who requires assisted ventilations produces frothy secretions as quickly as you can suction them. you should____
-suction airway for 15secs
-ventilate for 2 mins
-and alternate that pattern until secretions have cleared
airway adjunctions:
a _____ ____ prevents obstruction of the upper airway and allows for passage of air and oxygen to the lungs
airway adjunction
airway adjunctions:
the ____ ____:
-keeps the tongue from blocking the upper airway
-makes it easier to suction the oropharynx if necessary
oropharyngeal airway
airway adjunctions:
____ is used on unconscious patients without a gag reflex
oropharyngeal airway
airway adjunctions:
___ reflex is a protective reflex that keeps food from entering the airway
gag reflex
airway adjunctions:
the following are some things to consider when using the _____ _____
-good way to help maintain the airway of a spinal injury patient.
-may make the head tilt–chin lift and jaw-thrust maneuvers easier to perform.
-if too large could push the tongue back into the pharynx, blocking the airway.
-if too small could block the airway directly, like any foreign body obstruction.
oropharyngeal airway
airway adjunctions:
use a nasopharyngeal airway on a patient that_____
-unresponsive/altered mental status
-gag reflex
airway adjunctions:
consult medical control before inserting a nasopharyngeal airway on a patient who has sustained _____
trauma to the head or face
maintaining the airway:
The _____ position is used to help maintain a clear airway in an unconscious patient who is not injured and is breathing on his or her own with a normal
recovery position
maintaining the airway:
the recovery position is not for patients who have suspected ____ ____ or ____ injuries
spinal, hip, pelvic
supplemental oxygen:
aluminum oxygen cylinders are test every ____ years
5 years
supplemental oxygen:
composite cylinders are tested every ___ years
3 years
supplemental oxygen:
____ and ___ cylinders are used most often
___ cylinder remains on board the unit as a main supply tank
D and M cylinders
M cylinder
supplemental oxygen:
an alternative to compressed gas is ___ ____
liquid oxygen
supplemental oxygen:
___ ___ system prevents the wrong regulator being accidentally used on a different cylinder
pin-indexing system
supplemental oxygen:
pressure regulators ___ the cylinders pressure to a therapeutic range for the patient
reduce
supplemental oxygen:
regulators reduce the cylinder PSI to ___ to ___ PSI
40-70
supplemental oxygen:
never leave an ____ ____ standing unattended
oxygen cylinder
supplemental oxygen:
_____ ____ refers to damage to cells due to excessive oxygen levels in the blood
oxygen toxicity
supplemental oxygen:
patients experiencing ___ should be placed on oxygen
shock
supplemental oxygen:
when in doubt, or if unable to measure oxygen saturation reliably, supplemental oxygen should be administered.
true/false
true
Oxygen-Delivery Equipment:
what is the preferred way to give oxygen in the prehospital setting?
nonrebreathing mask
-capable of providing up to 90% inspiration
Oxygen-Delivery Equipment:
when using a nonrebreathing mask make sure the ___ is full before placing the mask on the patient
bag
Oxygen-Delivery Equipment:
adjust the flow rate on a nonrebreathing mask to ___L/min
10-15L/min
-if bag collapses, increase flow rate
Oxygen-Delivery Equipment:
____ deliver oxygen thru two small tubelike prongs that fit into the patients nostrils
nasal cannulas
Oxygen-Delivery Equipment:
nasal cannulas can provide ____% to ___% inspired oxygen whem the flow meter is set at ___ to___l/min
24% to 44% inspire oxygen
1-6L/min
Oxygen-Delivery Equipment:
for patient comfort flow rates above ___L/min are not recommended when using nasal cannulas
6L/min
Oxygen-Delivery Equipment:
if long transport time is anticipated, consider using ______
humidification
-nasal cannulas can irritate the mucous membrane lining of the nose( causing a nose bleed)
Oxygen-Delivery Equipment:
___ ___ ___ enriches the air mixture so that patients receive ___% to ___% oxygen
partial rebreathing mask
80% to 90% oxygen
Oxygen-Delivery Equipment:
to convert a nonrebreather mask to a partial mask remove the ___ ___ ___ and the reservoir bag
on way valve
Oxygen-Delivery Equipment:
_____ masks are medium flow devices that deliver ____% to ___ % of oxygen
venturi mask
24% to 40% oxygen
Oxygen-Delivery Equipment:
_____ masks cover the hole on the neck and have a securing strap
tracheostomy masks
Assisted and Artificial Ventilation:BVM
____ the bag everytime the patient breaths
squeeze
Assisted and Artificial Ventilation:BVM
after __ to ___ breaths deliver an appropriate tidal volume
5 - 10breaths
Assisted and Artificial Ventilation:
In normal breathing, the diaphragm contracts and _____ pressure is generated in the chest cavity, which sucks air into the chest.
negative
Assisted and Artificial Ventilation:
______-pressure ventilation generated by a device forces air into the chest cavity.
positive
Assisted and Artificial Ventilation:
_______ rates (for apneic patients with a pulse)
Adult: 1 breath per 5–6 seconds
Child: 1 breath per 3–5 seconds
Infant: 1 breath per 3–5 seconds
ventilation
Assisted and Artificial Ventilation:
the gas you exhale contains ___% of oxygen
16% oxygen
Assisted and Artificial Ventilation:
to increase oxygen concentration administer ____-flow oxygen at 15L/min
high
-combined with you exhaled breath, this will deliver 55% oxygen
Assisted and Artificial Ventilation:
who has the tidal volume of 1200-1600ml
an adult
Assisted and Artificial Ventilation:
who has the tidal volume of 50-700ml
pediatric
Assisted and Artificial Ventilation:
who has the tidal volume of 150-240ml
infant
Assisted and Artificial Ventilation:
if you have difficulty ventilating with a BMV you should____
switch to another method
Assisted and Artificial Ventilation:
when using a BVM the amount of volume you pump into the patient should be based on
chest rise and fall
Assisted and Artificial Ventilation:
_____ ____ occurs when ventilation fill the stomach with air
gastric distention
Assisted and Artificial Ventilation:
___ ___ ventilation devices allow a single rescuer to use both hands while also providing positive pressure ventilation
manually triggered ventilation
-also know as flow restricted, oxygen powered ventilation devices
Assisted and Artificial Ventilation:
manually triggered ventilation has a peak flow rate of ____% oxygen at up to ____L/min
100% at up to 40L/min
Continuous Positive Airway Pressure (CPAP):
A _____ increases pressure in the lungs, opens collapsed alveoli, pushes more oxygen across the alveolar membrane
a CPAP
Continuous Positive Airway Pressure (CPAP):
CPAP can cause a drop in a patients cardiac output
true/false
true
Continuous Positive Airway Pressure (CPAP):
if you see these signs you should use a ____
-The patient is alert and able to follow commands.
-The patient displays obvious signs of moderate to severe respiratory distress
-The patient is breathing rapidly, such that it affects overall minute volume (greater than 26 breaths/min).
-The pulse oximetry reading is less than 90%.
CPAP
Continuous Positive Airway Pressure (CPAP):
a pressure of 7-10 cm H2O is an acceptable therapeutic range
true/false
true
stomas:
if a patient has a stoma you should use what size mask on your BVM