Airway Management + O2

Question 1

Why is a jaw thrust more appropriate/safe on an unconscious patient?

Answer 1

Head tilt chin lift can cause issues with spinal damage in the case of C spine injury that you are unaware of

Question 2

Def: Airway Adjunct

Answer 2

Any technique or device that creates a pathway for air through the throat

Question 3

When would you use a manual suction device?

Answer 3

When the patient is vomiting or has lots of liquid in their mouth and throat but you cannot roll them to clear the airway

Question 4

What are the flow rates for the 4 O2 Delivery devices?

Answer 4

Nasal cannula - 1-4 LPM
Resuscitation mask - 6+ LPM
Non-rebreather - 10+ LPM
BVM - 15-20 LPM

Question 5

What situations are correlated to which O2 delivery devices?

Answer 5

Nasal Cannula + Standard mask- 91-94%

Rebreather and BVM - 90 or lower

Nasal Cannula and non rebreather only on breathing patients

BVM and standard mask on breathing and non breathing patients

Question 6

What are the 4 requirements for respiration to occur?

Answer 6

1. Open passage to the lungs
2. Lungs must be provided with sufficient oxygen
3. Gas exchange must occur
4. Lungs must inflate and deflate with effective rhythm

Question 7

Normal breathing rates for adults, children and babies?

Answer 7

Adult - 12-20 resp/min

Children - 16-24 resp/min

Babies - 30-40 resp/min

Question 8

What are the qualities of normal breathing?

Answer 8

Regular, quiet, effortless

Question 9

What does the timeline look like for the body once breathing has stopped?

Answer 9

0-4 mins: clinical death (heart stops pumping blood)
4+ min - biological death (organs and brain stop functioning)
4-6 min: brain damage possible
6-10 min: brain damage likely
10+ min: irreversible brain damage certain

Question 10

Def: Hypoxia

Answer 10

Condition where insufficient O2 reaches cells

Question 11

What can hypoxia cause?

Answer 11

Cyanosis
Increased RR and HR
Restlessness
Decreased LOR

Question 12

Def: Anoxia

Answer 12

Condition with a total lack of O2

Question 13

Def:
Eupnea
Apnea
Dyspnea

Answer 13

Eupnea: Normal respirations
Apnea: Cessation of breathing
Dyspnea: Difficult or laboured breathing including shortness of breath

Question 14

Respiratory distress vs Respiratory arrest?

Answer 14

Respiratory distress: Difficulty breathing
Respiratory arrest: Breathing has stopped

Question 15

What are some possible causes of respiratory emergencies?

Answer 15

Trauma
Inhaled toxins
Airway obstructions
Neurological injuries or conditions
Poor circulation
Lung infections
Excess fluid in lungs
Illness

Question 16

What could some causes of low O2 in the environment be?

Answer 16

High altitude
O2 displacement by other gas
O2 consumed (in a confined space)

Question 17

What vertebrae correlate to function fo the diaphragm?

Answer 17

C3-C5 keep the diaphragm alive!

Question 18

Def: Anaphylaxis

Answer 18

Severe allergic reaction that causes the air passage to constrict
Causes major dilation of blood vessels
Extremely low BP
Leads to cardiac collapse

Question 19

S+S: Anaphylaxis

Answer 19

Skin rash/hives
Itching
Weakness
Nausea
Dizziness
Dyspnea
Tightness of chest
Swelling of face/neck/tongue

Question 20

Def: COPD

Answer 20

Characterized by loss of lung function
Results in too much CO2 in system
Encompasses 3 clinical conditions:
- Emphysema
- Chronic bronchitis
- Bronchospasm

Question 21

S/S: COPD

Answer 21

SoB, gasping for air
Sitting upright, leaning forward
Barrel-chested appearance
Ronchi (rattling sounds in lungs)
Cyanosis
JVD

Question 22

Def: Emphysema

Answer 22

Disease in which alveoli lose elasticity and become distended with trapped air
Lungs lose ability to exchange CO2+O2
Often caused by smoking and develops over time

Question 23

S/S: Emphysema

Answer 23

SoB
Restlessness, confusion, weakness
Difficulty exhaling
Cyanosis, coughing, finger clubbing

Question 24

Def: Chronic Bronchitis

Answer 24

General term for inflammation of the bronchial tubes (itis = inflammation)
Results in excessive mucous secretions - which constricts smaller air passages and makes breathing more difficult
Acute - caused by infection, improves in days
Chronic - caused by prolonged exposure to irritants - lasts at least 3 months

Question 25

S/S: Chronic bronchitis

Answer 25

Shortness of breath Coughing with sputum Cyanosis

Question 26

Def: Bronchospasm

Answer 26

Condition that affects terminal bronchioles Swell and become fluid filled Muscles surrounding them contract, becoming further narrowed

Question 27

S/S: Bronchospasm

Answer 27

Shortness of breath Wheezing

Question 28

What drives healthy individuals to breathe? (what signals breathing?) How does that change for those with COPD?

Answer 28

Healthy people - amount of CO2 in blood drives people to breathe When CO2 rises, brain tells body to intake more O2 to compensate COPD - high levels of CO2 in blood for extended periods shuts off the CO2 sensors - thus turns into a hypoxic (low O2) drive to breathe

Question 29

Def: ARDS (Acute Respiratory Distress Sydrome)

Answer 29

Increased amount of fluid between alveolar membrane and the pulmonary capillaries surrounding them - leads to lower amount of O2 absorbed into blood Serious lung disease caused by a variety of direct and indirect conditions - often either other illnesses of the lungs or those who have suffered a significant chest trauma

Question 30

S/S: ARDS

Answer 30

Tachypnea (rapid breathing) SoB Cyanosis

Question 31

Def: Asthma

Answer 31

Inflammatory process resulting in the narrowing of air passages Triggered by allergens, emotional stress, cold weather, PA

Question 32

S/S: Asthma

Answer 32

Wheezing on exhalation - MOST COMMON SIGN Recurring dyspnea Chest tightness Sputum Cough Chest tightening

Question 33

What are the treatments for asthma and what are their goals?

Answer 33

Drug therapies Corticosteroids - treat inflammation; long term control and prevention Bronchodilators - rescue/relief - immediate control Goals for each are total control/prevention of symptoms

Question 34

Def: Pneumonia

Answer 34

Term used to describe a group of illnesses characterized by lung infection and fluid (or pus) filled alveoli that results in hypoxia Caused by bacteria, virus or irritants (e.g. smoke/aspirated materials)

Question 35

S/S: Pneumonia

Answer 35

Dyspnea, tachypnea, chills, nausea, sputum, pleuritic chest pain (sharp; worsens with breathing), fever, muscle aches

Question 36

Def: Acute Pulmonary Edema

Answer 36

Fluid backs up in pulmonary veins, excess fluid leaks into alveoli Oxygen entering blood decreases Caused by: Heart or lung damage (e.g. heart attack, left sided heart failure)

Question 37

S/S: Acute Pulmonary Edema

Answer 37

SoB (sudden onset) Tachypnea, dyspnea Cyanosis Restlessness Tachycardia Frothy sputum

Question 38

Def: Pulmonary Embolism

Answer 38

Caused by blockage (embolus) of a pulmonary artery by a clot or other substance that has travelled from somwhere else in the circulatory system Causes: Thrombus from a vein in lower extremity Fat Air Amniotic fluid Tumour tissue

Question 39

S/S: Pulmonary Embolism

Answer 39

SoB Cough Pain Anxiety Syncope (fainting/passing out) Hypotension Cool, clammy skin Tachycardia

Question 40

Def: JVD

Answer 40

Hyper-dilation of the jugular vein - any backup of blood in the heart causes a backup in the jugular vein, presenting in JVD

Question 41

What are some caues of hyperventilation?

Answer 41

Hyperventilation (aka tachypnea) - upsets O2 + CO2 balance Causes: anxiety Head injury/hemorrhage Heart failure Asthma Exercise

Question 42

S/S: Hyperventilation

Answer 42

Shallow/rapid breathing - most characteristic sign Dizziness N/T in fingers and toes

Question 43

What are the general Tx for respiratory emergencies?

Answer 43

O2 adminstration Maintain normal body temperatures Rest in a comfortable position Reduce environment heat/humidity

Question 44

What is respiratory arrest generally preceded by?

Answer 44

Respiratory DISTRESS - respiratory arrest almost never occurs spontaneously!

Question 45

What is the difference between pneumonia and ARDS?

Answer 45

Pneumonia is fluid that is filling the lungs, which reduces gas exchange due to less surface area ARDS is fluid between the alveolar membrane and the pulmonary capillaries which makes gas exchange less efficient - allows less O2 into the bloodstream

Question 46

Chronic bronchitis vs bronchospasm?

Answer 46

Chronic bronchitis - inflammation of the airways - long term issue caused by something like smoking Bronchospasm - short term attack which can be a result of bronchitis or asthma. Inflammation of terminal bronchioles along with fluid production and muscle constriction