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EMT > Chapter 10 > Flashcards

Chapter 10 Flashcards

1
Q

Pulmonary ventilation

A

simply the mechanical process of moving air in and out of the lungs

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2
Q

External Respiration

A

gas exchange that occurs between the alveoli and the surrounding pulmonary capillaries - alveoli/capillary gas exchange in lungs

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3
Q

Internal Respiration

A

gas exchange that occurs between the cells and the systemic capillaries - cell/capillary gas exchange with cells

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4
Q

What organs are in the upper airway?

A

Nasal Cavity - turbinates and palates
Nasopharynx - tonsils.adenoids, uvula
Oropharynx - tongue
Laryngopharynx - vallecula and epiglottis
Larynx - esophagus, trachea, vocal cords, glottic opening, thyroid/cricoid cartilage, thryroidgland

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5
Q

Thyroid Cartilage

A

Adam’s apple

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6
Q

cricoid cartilage

A

only circular cartilaginous ring of the upper airway

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7
Q

What organs make up the lower airway?

A

Trachea, carina, bronchi, bronchioles, lungs, alveoli

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8
Q

Pleura

A

2 layers of connective tissue that help inflate and deflate the lungs

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9
Q

Visceral pleura

A

innermost covering of lung

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10
Q

Parietal pleura

A

adheres to the inner potion of the chest wall

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11
Q

serous fluid

A

lubricant to reduce friction between pleurals

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12
Q

pleural space

A

small space with negative pressure between the two pleural layers

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13
Q

What is the process of Inhalation?

A

intercostal muscles (in ribs) contract, diaphragm loves down and out, ribs outk sternum up, increase chest cavity creating negative pressure in chest cavity that draws in air thru mouth and nose - active process

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14
Q

What is the process of exhalation

A

the diaphragm and intercostal muscles relax, diaphragm moves up, ribs and sternum relax down and in, chest cavity is reduced, pushes air out - passive process

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15
Q

Chemoreceptors monitor the levels of what?

A

oxygen, carbon dioxide and pH in the blood and stimulate impulses DRG, CRG and pontine

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16
Q

hypercarbic

A

high carbon dioxide

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17
Q

Oxygenation

A

process by which the blood and cells become saturated with oxygen

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18
Q

Hypoxemia

A

low oxygen content in the arterial blood

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19
Q

Hypoxia

A

inadequacy of oxygen delivered to the cells

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20
Q

hypoperfusion or shock

A

inadequate perfusion of the cells

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21
Q

Signs of mild to moderate hypoxia

A

tachypnea and dyspnea (increased or decreased resp rate), pale cool clammy skin, tachycardia (increased heart right, increased blood pressure, restlessness, agitation, disorientation and confusion, headache

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22
Q

Signs of severe hypoxia

A

tachypnea, dyspnea, cyanosis, tachycardia, irregular heart rhythms, severe confusion, loss of coordination, sleepy, head bobbing, slow reaction, altered mental status, seizure

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23
Q

tachypnea

A

increased respiratory rate

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24
Q

dyspnea

A

shortness of breath

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25
Q

tachycardia

A

increased heart rate

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26
Q

cyanosis

A

bluish gray color to skin, nails and mucous membranes

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27
Q

dysrhythias

A

irregular heart rhythems

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28
Q

bradycardia

A

slow heart rate

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29
Q

Positive Pressure Ventilation - PPV

A

forcing air into lungs - artificial ventilation

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30
Q

What are signs of an open and patent airway?

A

air can be felt and heard moving in and out of mouth, speaking in full sentences with little difficulty, sound of the voice is normal for the patient

31
Q

Snoring

A

sonorous sounds - upper airway is partially obstructed

32
Q

crowing

A

sound like cooing that occurs when muscles around the larynx spasm and narrow the opening to the trachea

33
Q

gurgling

A

sound like gargling, indicates the presence of blood, vomit or other liquid in the airway

34
Q

stridor

A

harsh, high pitch sound from swelling in the larynx, or obstruction by food

35
Q

Mounted Suction Devices

A

fixed installed units onboard an ambulance, airflow of >40 lpm, vacuum more than -300 mmhg when tube is clamped

36
Q

Portable Suction Device

A

pressure of -80 to -120 mmHg is necessary to suction (-300 when hose is clamped)
electric, oxygen, air or hand powered

37
Q

Rigid Suction Catheters

A

hard catheter or Yankaur catheter “tonsil tip” or “tonsil sucker” - for unresponsive patient - more effective for particulate matter

38
Q

French Catheter

A

soft catheter, flexible tubing when rigid cannot be used (length determined by measuring tip of nose to ear for naso, or corner mouth to tip of ear if oro)

39
Q

If a patient needs artifical ventilation, how do you suction?

A

apply suction for 15 seconds, provide PPV with oxygen for 2 minutes then suction for 15 seconds

40
Q

Risidual volume

A

air remaining in the lungs after maximal exhalation

41
Q

Airway Adjuncts

A

inserted and used to keep airway open (oropharyngeal and nasopharyngeal -) extend but do not pass through the larynx

42
Q

Oropharyngeal airway (oral airway) OPA

A

semicircular hard plastic or rubber that holds the tongue away from the back of the airway - enter and turn 180 degrees or inserted sideways and rotated 90 degrees, must be unresponsive

43
Q

How do you determine the size of OPA?

A

front of teeth to the angle of the jaw or from corner of mouth to the tragus of the ear

44
Q

Nasopharyngeal airway (nasal airway) NPA

A

soft tube with flange at the top end - used if oral can’t be used, can be used on not fully responsive and needs assistance

45
Q

How do you determine the size of NPA?

A

tip of the nose to the tip of the earlobe , diameter must be able to fit inside the patients nostril without blanching the skin

46
Q

What are 4 ways to assess breathing?

A

Look, Listen Feel Auscultate (stethoscope)

47
Q

What determines adequate breathing?

A

Rate, Rhythm, Quality, Depth

48
Q

Respiratory Arrest (Apnea)

A

completely stopping to breath

49
Q

Respiratory Failure

A

respiratory rate or tidal volume is insufficient resulting in hypoxia to cells and organs

50
Q

Agonal Respirations

A

gasping type breaths

51
Q

Tachypnea

A

rapid breathing

52
Q

Bradypnea

A

slow breathing

53
Q

What can happen if you are ventilating too fast?

A

gastric distension

54
Q

BURP

A

backward, upward, rightward pressure

55
Q

ELM

A

External laryngeal manipulation

56
Q

If a patient has an advanced airway in place (endotracheal tube) without a pulse, how many ventilations per minute?

A

10 ventilations per minute, continuous chest compressions without pausing for ventilation

57
Q

FROPVD

A

flow restricted oxygen powered ventilation device - powered by oxygen with proper mask seal and 100 percent oxygen delivery

58
Q

ATV

A

automatic transport ventilator

59
Q

Ventilation of a patient who is breathing spontaneously

A

assess the need for ventilation, 10-12 goal, adjust slowly to get to 10-12

60
Q

CPAP

A

continuous positive airway pressure, noninvasive positive pressure ventilation, respiratory disease or cardiac failure

61
Q

BiPAP

A

bilevel positive airway pressure , like cpap but allows you to set different airway pressures for inspiration and expiration

62
Q

stoma

A

surgical opening in the front of the neck through which a patient breathes air into the trachea

63
Q

tracheostomy

A

stoma is created by cutting the skin and into the trachea to relieve an obstruction higher in the trachea or to serve in place of an endotracheal tube

64
Q

laryngectomy

A

usually because of cancer, part of larynx has been removed

65
Q

How do you calculate oxygen tank duration?

A

tank pressure in psi minus risidual pressure (200) and multiple the constant (based on size) and divide by the flow rate epected to be delivered
full tank at 15 liters a minute would be
(2000-200)x.28 (for E) and divide by 15

66
Q

pressure regulator

A

reduces high pressure in the cylinder to a safe range and controls the flow of oxygen

67
Q

Therapy regulator

A

2 gauges one for pressure in the tank and one to measure the flow of oxygen being delivered

68
Q

What are some indications you should administer oxygen?

A

SpO2 <94%, complains of dyspnea or exibits signs of respiratory distress, pale, cool and clammy skin, decreased mental status, signs of heart failure, suspected shock, any situation in which hypoxia or hypoexmia are suspected

69
Q

Steps to administer oxygen

A
  1. check cylinder to be sure it contains oxygen, remove seal
  2. open and shut quickly to remove dust
  3. place therapy regulator and align pins and tighten
  4. open main cylinder valve to check pressure gauge
  5. attach mask or cannula
  6. open flow control and set number
  7. apply to patient
70
Q

non rebreather mask

A

oxygen reservoir bag attached to a mask with a one way valve between that prevents exhaled air from mixing with oxygen

71
Q

nasal cannula

A

preferred device to deliver oxygen to most patients. limited oxygen concentration from 24 to 44%. 1 to 6 lpm

72
Q

simple face mask

A

oxygen mask can deliver up to 60%

73
Q

Venturi mask

A

low flow oxygen COPD patients

74
Q

Tracheostomy mask

A

deliver aerosolized medication, bland aerosol therapy or oxygen with trachestomy tube

EMT (7 decks)

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