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Emergency Medical Technician > Airway Management - CPAP, Stomas, Obstructions, & ALS Assist > Flashcards

Airway Management - CPAP, Stomas, Obstructions, & ALS Assist Flashcards

(71 cards)

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1
Q

Alveolar collapse

A

Atelectasis

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2
Q

What does the CPAP do?

A

Increases pressure in the lungs, opens collapsed alveoli and prevents further alveolar collapse, pushes more oxygen across the alveolar membrane, and forces interstitial fluid back into the pulmonary circulation

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3
Q

Desired effect of the CPAP

A

Improve pulmonary compliance and make spontaneous ventilation easier for the patient

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4
Q

Many CPAP systems use ___ as the driving force to deliver positive ventilatory pressure

A

Oxygen

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5
Q

Some CPAP units can empty a D cylinder in ___

A

5 to 10 minutes

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6
Q

CPAP pressure relief valve determines ___

A

The amount of pressure the patient must breathe against and overcome

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7
Q

The amount of pressure the patient must breathe against and overcome

A

Expiratory positive airway pressure

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8
Q

EPAP

A

Expiratory positive airway pressure

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9
Q

CPAP EPAP setting typically ranges between ___

A

5 and 20 cm H2O

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10
Q

As a patient breathes against the EPAP, positive pressure is redirected to the ___

A

Lower airway

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11
Q

Patients benefit the most from CPAP during ___

A

Exhalation rather than inhalation

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12
Q

CPAP lowers the ___ of the heart

A

Cardiac output

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13
Q

CPAP is for ___

A

Patients experiencing respiratory distress in which their own compensatory mechanisms are not enough to keep up with the oxygen demand

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14
Q

General indications for using CPAP

A
  1. Patient is alert and able to follow commands
  2. Patient is displaying obvious signs of moderate to severe respiratory distress from an underlying pathology, such as pulmonary edema or obstructive pulmonary disease, or bronchospasm
  3. Respiratory distress occurs after a submersion incident
  4. Patient is breathing so rapidly that it affects overall minute volume
  5. Pulse oximeter reading is less than 90%
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15
Q

General contraindications for using CPAP

A
  1. Patient is in respiratory arrest or has agonal respirations
  2. Patient is hypoventilating
  3. Patient cannot speak
  4. Patient is unresponsive or otherwise unable to follow verbal commands
  5. Patient cannot protect their own airway
  6. Patient has hypotension
  7. Signs and symptoms of pneumothorax or chest trauma are present
  8. Patient has a tracheostomy
  9. Active gastrointestinal bleeding, nausea, or vomiting is present
  10. Patient has experienced facial trauma
  11. Patient is in cardiogenic shock
  12. Patient cannot sit upright
  13. CPAP system mask and strap cannot properly fit
  14. Patient cannot tolerate the mask
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16
Q

If CPAP is on a patient who deteriorates ___

A

Initiate positive-pressure ventilation with a bag-mask device attached to high-flow oxygen

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17
Q

CPAP units generally comprise a ___

A
  1. Generator
  2. Mask
  3. Circuit with corrugated tubing
  4. Bacteria filter
  5. One-way valve
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18
Q

The CPAP generator creates resistance that creates ___

A

Back pressure into the airways that pushes open the smaller airway structures as the patient exhales

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19
Q

CPAP pressure of __ is a generally acceptable therapeutic range

A

7.0 to 10.0 cm H2O

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20
Q

A typical CPAP unit will deplete a full D cylinder of oxygen in ___

A

15 to 30 minutes

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21
Q

The rate a CPAP oxygen bottle is depleted depends on ___

A

The fraction of inspired oxygen (FIO2) setting

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22
Q

Position for patient when using CPAP mask

A

High Fowler position

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23
Q

Valve to adjust CPAP

A

PEEP valve

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24
Q

PEEP valve

A

Positive end-expiratory pressure valve

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25
The high pressure of the CPAP could cause a ___
Pneumothorax
26
A patient with a tracheostomy may have numerous holes in the neck, you should ignore any opening other than the ___
Midline tracheal stoma
27
If a patient has a tracheostomy tube, ventilate ___
Through the tube with a bag mask device and 100% oxygen attached directly to the device
28
If a patient has a stoma and no tube is in place ___
Use an infant or child mask to make a seal over the stoma, and seal the patient's mouth and nose with one hand. Release the seal on the mouth and nose for exhalation
29
If you are unable to ventilate a patient with a stoma, try ___
Suctioning the stoma and the mouth with a French or soft-tip catheter before giving artificial ventilation through the mouth and nose
30
If you seal the stoma during ventilation via the nose or mouth, the ability to ___
Ventilate the patient may be improved, or it may help to clear any obstructions
31
An otherwise healthy child sho has supine difficulty breathing should be assumed to have ___
A foreign body airway obstruction
32
Difference between mild and severe airway obstruction
Severe completely blocks the airway
33
With good air exchange, the patient can ___
Cough forcefully, may hear wheezing
34
Production of whistling sounds during respiration
Wheezing
35
Wheezing is usually indicative of ___
A mild lower airway obstruction
36
With poor air exchange, the patient has ___
A weak, ineffective cough and may have increased difficulty breathing, stridor, and cyanosis
37
High-pitched noise heard primarily on inspiration
Stridor
38
Stridor is an indication of ___
A mild upper airway obstruction
39
For patients with a mild airway obstruction with poor air exchange, ___
Treat immediately as if there is a severe airway obstruction
40
Patients with a ___ are still able to exchange air but will have varying degrees of respiratory arrest
Mild airway obstruction
41
Patients with a ___ cannot breathe, talk, or cough
Severe airway obstruction
42
Most effective method to dislodge and force an object out of the airway of a conscious person
Abdominal thrusts
43
Use abdominal thrusts until __
The object dislodges or the patient becomes unconscious
44
For an unresponsive patient with severe foreign body airway obstruction, after the 30 compressions, perform ___
A tongue-jaw lift by grasping the jaw with your thumb and index finger. Place your thumb onto the tip of the patient's lower teeth and tongue while placing your index finger under the body portion of the chin. Pull jaw/mouth open and look at the back of the oropharynx for foreign objects, and remove it if seen
45
Dental appliance that do not stay in place during ventilations should be ___
Removed
46
If dentures become dislodged ___
Place them in a container and transport them with the patient
47
Because blood supply to the face is so rich, injuries to the face can result in ___
Severe tissue swelling and bleeding into the airway
48
EMT role while ALS partner performs advanced airway intervention
1. Help set up the procedure 2. Perform BLS airway and ventilation maneuvers 3. Help monitor the patient
49
The insertion of a tube into the trachea to maintain and protect the airway
Endotracheal (ET) intubation
50
The ET tube can be inserted through ___
The mouth or nose
51
The ET tube passes directly through the ___ and then into the ___
1. Larynx between the vocal cords 2. Trachea
52
First step in preparing a patient for ET intubation
Oxygenation
53
The process of providing oxygen, often in combination with ventilation, prior to intubation to raise the oxygen levels
Preoxygenation
54
A technique in which oxygen administered via a high-flow nasal cannula is left in place during an intubation
Apneic oxygenation
55
Visualization of the vocal cords with a laryngoscope
Direct laryngoscopy
56
Visualization of the vocal cords using a video camera and monitor
Video laryngoscopy
57
Intubation equipment sets include ___
1. PPE 2. Suction unit with rigid, tonsil-tip (Yankauer) and nonrigid, whistle-tip (French) catheters 3. Laryngoscope handle and blade 4. Magill forceps 5. ET tube 6. Stylette or tube introducer (Gum elastic bougie) 7. Water-soluble lubricant 8. 10-mL syringe 9. Confirmation device, including waveform end-tidal CO2 monitors and/or colorimetric device 10. Commercial ET tube securing device 11. Alternate airway management devices
58
Six critical steps for ET intubation
B: perform Bag-mask pre oxygenation E: Evaluate for airway difficulties M: Manipulate the patient A: Attempt first-pass intubation GI: use a supraGlottic airway if unable to intubate C: Confirm successful intubation/Correct any issues
59
Do not ___ the patient during the pre oxygenation phase of intubation
Hyperventilate
60
Ideal position for patient for intubation
Patient's ear canal is on the same horizontal plane as their sternal notch
61
Patient's ear canal is on the same horizontal plane as their sternal notch
Sniffing position
62
A cervical collar will need to be ___ before intubation typically
Undone
63
When the ALS provider is ready to begin the intubation attempt ___
Remove the oral airway and disconnect the mask from the bag in preparation for connecting the bag to the ET tube
64
When the ALS provider is attempting intubation, always keep ___ at hand
Mask and airway and suction equipment
65
A successfully intimated patient should have ___
End-tidal CO2 waveform, bilateral breath sounds present, and gastric (or epigastric) sounds absent
66
An intubated patient end-tidal CO2 waveform suddenly disappears is an indication of ___
The ET tube may have shifted out of the proper position
67
An intubated patient SpO2 levels begin to drop is an indication of ___
The ET tube may have shifted out of the proper position
68
ET tube is mistakenly placed in the esophagus rather than the trachea
Esophageal intubation
69
Esophageal intubation results in ___
Gastric distention as air is pumped into the stomach
70
An intubated patient has increasing resistance while ventilating indicates ___
Possible esophageal intubation
71
What to monitor with an intubated patient
1. End-tidal CO2 level 2. SpO2 level 3. Ventilation resistance 4. Physical signs of poor ventilation and perfusion 5. Improper positioning or dislodgment of the ET tube

Emergency Medical Technician (100 decks)

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