Oxygenation Pt.1 Flashcards
Partial vs Complete Airway Obstruction?
Partial: breathe and cough spontaneously; encourage pt to cough forcefully habang kaya pa!; if not removed = hypoxia, hypercarbia, respi + cardiac arrest
Complete: weak, ineffective cough + high pitch noise w inhalation; can’t dislodge object w cough na; hypoxia; permanent brain injury / death within 3 TO 5 MINUTES
Causes of airway obstruction?
- Aspiration of foreign bodies
- Anaphylaxis (allergic reax; observe 30m-1h after exposure)
- Viral / bacterial infection (d/t abscess or secretions)
- Trauma (smoke, chemicals)
- Inhalation / chemical burns
- Asphyxiation by food
Most common reasons for aspiration in:
Children
Adults
Unconscious pts
C: Small toys or coins
A: boules of meat
U: may nagbigay ng oral fluids
In aspiration, objects commonly go to which bronchus?
RIght, which is more direct compared to left
Assessment findings in airway obstruction?
- Clutching neck between thumb + finger = UNIVERSAL SIGN
- Weak, ineffective cough, high pitch noises = total obstruction na
- Respi distress
- Unable to speak, breathe, cough
- Collapse
- No breath sounds
Pulse Oximeter - monitor O2; severe = low
Serum ABG - changes in pH, CO2
Management of Airway Obstruction includes:
Establish patent airway:
- Abdominal thrust / Heimlich maneuver
- Head tilt, chin lift if no SCI; else, use jaw-thrust
- Oropharyngeal airway insertion / ETT
- Cricothyroidotomy (insert needle sa may thyroid area so air would go in)
Provide artificial means of ventilation
What is near drowning?
Survival for at least 24h after submersion (Water causes obstruction)
Most common consequence of near drowning?
Hypoxemia; could lead to death by suffocation from submersion
Fresh water drowning vs salt water drowning
Fresh water
- hypotonic; fully water kaya nagsswell ang cells
- lungs r filled w water kaya no space for air
- leads to cardiac and respi arrest
Salt water
- hypertonic; may nakahalong salt = more concentrated = shrinked, wrinkly cell
- salt attracts water to the lungs which leaves blood with no O2
- pulmo edema, cardiac arrest, hemoconcentration, drowning in ur own blood
Management for near drowning?
First Aid: CPR for both types, stabilize spine
Management:
- ET with PEEP
- Rewarming
- ECG for monitoring
- Foley cath
- NGT
Prevention of near drowning?
- Test water depth
- No ETOH (alak)
- Ensure availability of rescue equipment
Decompression sickness is AKA?
The bends, Caisson’s Disease, chokes, staggers
What happens in DCS?
- Person starts ascending too fast and di makakeep up ang body para irelease ang absorbed Nitrogen
- Happens at tissue level, which will eventually form gas bubbles and create a blockage
- Can lead to platelet aggregation > blood clots > emboli
Manifestations of DCS?
- “Bends” : joint, extremity pain, loss of ROM
- Cardiopulmonary arrest d/t hypoxia
- Chokes: abnormal gas exchange + hemodynamic compromise
- Air embolism: stroke, paralysis, death - neuro symptoms that mimic stroke/SCI
Management of DCS?
100% O2, CXR, IV line w LRS or NSS, warm pt, transfer to closest hyperbaric chamber, resuscitate if unconscious, fluids, antibx
HOB SHOULD BE LOWERED to save brain from clots
