Respiratory Cards Deck 1 Flashcards
(38 cards)
When is it appropriate to use the Heimlich maneuver on the choking patient ?
Not until there is a complete blockage of air. You do NOT want to give the Heimlich maneuver until there is a complete blockage of air. If there is not a complete blockage of air, the best treatment would be encouraging the patient to cough and transport them to the hospital.
Dispatch has reported a 59 yr old woman with an altered level of consciousness. When you arrive on scene, the patient’s husband tells you that the woman has been vomiting for half of the day. She is pale and diaphoretic with a thready pulse. Your partner takes a blood pressure and gets a reading of 78/46. What would be the best choice of treatment for this patient?
CORRECT ANSWER is:
Oxygen at 15 LPM via NRB and immediate transport
This woman is in need of high flow O2 and immediate transportation to the hospital. It is wrong to get a repeat set of vitals prior to making a transport decision. Additionally, a Non Re-Breather mask is used for high flow O2, not a nasal canula.
Pericardial tamponade, a rare condition in which the heart is impeded by fluid in the pericardium.
It will result in a low BP and muffled heart sounds with a very weak pulse as the heart struggles to pump.
Anaphylactic shock
The best course of action would be to address the immediate life threat, that is the airway compromise caused by the anaphylaxis.
Definitive treatment for anaphylaxis is epinephrine injected intramuscularly at a 90 degree angle.
During anaphylactic shock the vessels dilate and fluid leaks from the vessels into the body’s tissues, resulting in swelling and urticaria.
Purposes of OPA
The purposes of an Oropharyngeal airway include: Make it easier to suction oropharynx, keep the tongue from blocking the upper airway, and allow the passage of air to the lungs. It has no impact on the lower airway.
Exhalation is an active part of breathing.
Exhalation is the passive part of breathing. During exhalation the diaphragm and intercostal muscles relax, the intrathoracic pressure increases, and air moves out of the lungs.
You are called to a youth summer camp for a 12 year old girl having difficulty breathing. En route to the camp you are told that a group of kids were having lunch when a hive of bees was disturbed near by. The kids took off running and when they stopped the patient began having a hard time breathing. She has no known allergies. What is the best course of action?
Ask the girl if she is choking. Initiate treatment and immediate transport in a position of comfort.
Rationale:
Before you initiate any treatment for this patient you will want to confirm the cause of the breathing difficulty if you can. Just because there are bees present do not assume that she is going into anaphalaxis. The kids were having lunch and there is a good chance that the girl has an airway obstruction caused by food. Do not put an oxygen mask on a patient who has a possible FBAO as it may excacerbate the respiratory problems.
Nitroglycerin is used to ?
Dilate the blood vessels.
Vasodilation is the desired effect of nitroglycerin, helping reduce the workload on the heart.
Air inhaled is 16% oxygen
Air exhaled is 21% oxygen
Air in the atmosphere that we breath in has approximately 21% oxygen. The air that we exhale has about 16%.
Pneumonia can cause septic shock.
Septic shock is often caused by pneumonia, a severe inflammation of the lungs caused by both viruses and bacteria. It is a contagious disease in which you should utilize masks for both you and the patient to help minimize the possibility of transmission. It has fairly rapid onset, and like other respiratory problems, can cause the patient to be anxious and fearful.
Sign/Symptom
Symptoms are patient described and they cannot be measured or observed. A sign is something you can see, feel, hear, or measure like the bone sticking out.
Which of the following is a sign that your patient could be perfusing poorly?
Poor Mentation
Poor respiratory function may be part of the cause of hypoperfusion but it is not a sign. Capillary refill needs to be more than 2 seconds. Poor mentation is a sign of hypoperfusion.
Your are assisting a patient with ventilation.
What are the steps…… ?
The steps in ventilating a patient include: 1st - Explain the procedure to the patient. 2nd - Place mask over the patient’s nose and mouth. 3rd - Initially assist at a rate at which the patient is breathing. 4th - Squeeze the bag each time the patient begins to inhale. 5th - Over the next 5-10 breaths, slowly adjust the rate and volume.
The amount of air that can be forcibly expelled from the lungs after breathing deeply is called:
Vital Capacity
The amount of air that can be forcibly expelled from the lungs after breathing deeply is called vital capacity. Dead space is the amount of tidal volume not reaching the alveoli during ventilation. Residual volume is the volume of air remaining in the lungs after maximum exhalation. Minute volume is the volume of air inhaled and exhaled by the lungs over a minute.
Pertinent negatives are often used when documenting patient conditions on a PCR. Which of the following is a pertinent negative for a patient experiencing an MI?
The patient denies chest pain
A pertinent negative is a symptom or condition you would expect to see under certain circumstances, but is not present with a particular patient.
Fractures of the tibia and fibula commonly include?
Damage to the Vessels
Fractures of the lower bones of the leg often include damage to the veins and arteries of the leg as the sharp edges of the broken bones cut through them and other tissue during the break.
You and your partner Dave arrive on scene at a softball field where your patient is a 22 year old female softball player. She is complaining of ankle pain after sliding into 3rd base. Swelling and discoloring are apparent. What assessment should you use?
Focused Trauma
If you know that the chief complaint is a localized trauma injury you can use a focused trauma to evaluate the specific injury.
In the context of pulmonary ventilation, internal respiration is best described as:
The exchange of respiratory gases between the systemic capillaries and their surrounding tissue beds
Internal respiration is the exchange of respiratory gases between the systemic capillaries and their surrounding tissue beds.
Basal Skull Fracture
CSF drainage from the nose, raccoon eyes, and Battle’s sign are all indicators of a Basal skull fracture.
Irregular Breathing Problems
An irregular respiratory pattern can be caused by: Head trauma, stroke, metabolic dysfunction, toxic environment, and a rapid respiratory rate without clinical improvement. In some cases, cushings triad can develop as the patient’s ICP increases.
The girl is having problems breathing. The girl’s parents tell you that she has never had any problems like this before. The mother says the child has had the flu for a few days, but the girl woke up this morning complaining of difficulty breathing for the first time. As you visually inspect this 7-year girl you see her utilizing accessory muscles to breath and her nostrils are flaring. She is breathing at 20 respirations per minute and her skin is warm and dry.
Epiglottitis is known to strike children in this age group. Transporting with airway support via an NRB is the best treatment. Given the assessment, she does not need positive pressure ventilations at this point.
Cells require chemicals in order to function, namely oxygen, glucose, and electrolytes.
Cell functions requiring chemicals include: Excretion of water, excretion of carbon dioxide, and aerobic versus anaerobic respiration.
The left side of the heart ________________________ and ________________________.
receives pulmonary circulation, drives systemic circulation
The left side of the heart receives pulmonary circulation and drives systemic circulation.
Contraindications of inserting a NPA
Inserting a nasopharyngeal is not recommended in patients who have sustained possible basilar fractures as the device may enter and injure the brain through a fracture.
