Flashcards in Breathing and Ventilation Deck (16):
What does B stand for in the primary assessment?
breathing and ventilation
What do you have to do first to assess for breathing and ventilation?
How do you inspect for breathing/ventilation?
- spontaneous breathing
- symmetrical rise/fall of chest
- depth, pattern, and rate of respiration
- respiratory difficulty (accessory muscle or diaphragmatic breathing)
- skin color (normal, pale, flushed, cyanotic
- contusions, abrasions, or deformities)
- open pneumothoraces (sucking chest wound)
- JVD and displaced trachea (tension pnuemothorax)
- inhalation injury (signed nasal hair, carbonaceous sputum)
What do you want to auscultate for in breathing?
presence, quality and equality of breath sounds
Where do you want to auscultate for breath sounds?
- second intercostal space midclavicular line
- bases of the fifth intercostal space at the anterior axillary line
What do you want to palpate for in breathing/ventilation?
- bony structure, rib fx (may impact ventilation)
- subcutaneous emphysema (sign of pneumothorax)
- soft tissue injury
- jugular venous pulsations at the suprasternal notch or supraclavicular area
What interventions do you do if breathing is absent?
- open airway (jaw thrust and cervical spinal stabilization)
- insert oral airway adjunct
- assist ventilations with a bag-mask device
- prepare for a definitive airway
What do you do if breathing is present?
administer O2 at 15 L/min via nonrebreather mask with reservoir bag
What happens when there is an inability to maintain adequate oxygenation?
hypoxemia resulting in anaerobic metabolism and acidosis
Do trauma patients need early supplemental oxygen?
Why do you want to monitor and titrate oxygen?
to avoid detrimental effects of hyperoxia
How do you determine if ventilation is effective?
- end tidal carbon dioxide (ETCO2) is 35-45 mm Hg
- SpO2 of 94% or higher
What signifies depressed ventilation?
ETCO2 above 50 mm Hg
What do you do if ventilation is ineffective?
- assist ventilation with bag-mask device attached to O2 at 15 L/min, 10 to 12 breaths/min or every 5-6 seconds
- determine need for a definitive airway
What needs to be identified prior to moving from B to C in the primary assessment?
identify life threatening pulmonary injuries