ubit 4

Question 1

why might an injury stop the drive to breathe

Answer 1

a spinal chord injury above C3 would prevent the phrenic nerve from signaling the diaphragm to contract or relax.

Question 2

how does the phrenic nerve work

Answer 2

chemoreceptors in the blood monitor the amount of Co2 and O2 in the blood then tell the brain to signal the phrenic nerve to adjust depth of breathing

Question 3

what do the intercostals do when breathing in

Answer 3

external intercostals contract to raise the ribs

Question 4

what do the intercostals do when exhaling

Answer 4

internal intercostals contract to lower the ribs

Question 5

when assessing breathing what are you looking for

Answer 5

equal and even chest rise. Flail chest and paradoxical (chest moving opposite to correct direction) motion indicate serious issues. responsiveness and pulse, airway, sound of breathing, rate of breath, skin color, accessory muscle movement, restlessness or anxiety

Question 6

order of assessment when possible breathing problem

Answer 6

check pulse, check airway, check breathing.

Question 7

what is a good respiratory rate for each of the classes

Answer 7

adults 12-20, children 18-30, infant 20-40

Question 8

head tilt chin lift

Answer 8

used for patients with no traumatic injury. when attempting on children, use less tilt (sniffing position) or simply place something under their shoulders.

Question 9

jaw thrust

Answer 9

lift the mandible without moving the neck to lift the tongue from the airway. done when trauma is suspected.

Question 10

how do you check airway

Answer 10

look in patient’s mouth. If object is visible, turn the patient onto their side and do a finger sweep. move side to side until you capture the object. if suctioning is necessary, use a rigid catheter (yankauer) by turning the head to the side and removing the fluid. When using the catheter, only do increments of 15 seconds so the patient may be allowed to breathe or be given a rescue breath.

Question 11

recovery position

Answer 11

used when a patient is effectively breathing on their own but is unable to protect their own airway. keeps tongue off pharynx and allows suction to drain.

Question 12

oropharyngeal airway (OPA)

Answer 12

maintains open airway by lifting the tongue off the back of the throat. creates a pathway for suction. can only be used on unconscious patient with no gag reflex.

Question 13

nasopharyngeal airway (NPA)

Answer 13

maintains open airway by inserting into the nose with lubricant. you know the amount to use by measuring from earlobe to nose. Can be used on patients with a gag reflex because it doesnt go down the throat.

Question 14

Bag-Valv Mask

Answer 14

ambu bag. sized masks with 1 way valve. self inflatable and can be attached to an oxygen source.

Question 15

what do barrier devices do

Answer 15

they have a 1 way valve that protects the rescuer

Question 16

how do you deliver rescue breaths as a single rescuer

Answer 16

check responsiveness and pulse, use head tilt or jaw thrust to open the airway, and then look in mouth for blockage. Assess breathing. Deliver 1 breath using 1 hand. If chest rises, continue. If it doesnt, readjust the airway/bag.

Question 17

how to give rescue breaths

Answer 17

ensure airway isnt blocked, do an airway opening method (HTCL or JT). Deliver 2 breaths that last for 1 second and arent too hard/fast. wait 1 second between breaths and watch for chest rise. If there isnt any, adjust airway and try again. If there is, continue with breaths every 5/6 seconds (3-5 in infants/children).

Question 18

how should you modify rescue breaths to children

Answer 18

tilt head less when opening airway, if you have to use an adult ambu bag, just dont squeeze as much.

Question 19

when should you remove dental appliences to give rescue breaths

Answer 19

only when they are loose/in the way

Question 20

what is gastric distension

Answer 20

if you squeeze bag too hard or if airway isnt open, the stomach may fill with air which might cause vomitting and difficulty giving further breaths

Question 21

mild airway obstructionm

Answer 21

partial block. coughing, strider (high pitched sound coming from throat). encourage patient to cough and do not leave

Question 22

severe obstruction

Answer 22

complete block of airway

Question 23

doing abdominal thrusts (Heimlich)

Answer 23

ask if choking, get behind patient with 1 leg between theirs. place fist just above belly button and push hard/fast in and up. continue until object dislodged or unconscious patient. If patient goes unconscious, lower to ground and call 911. do 30 chest compressions, look in mouth, attempt rescue breaths. if no chest rise, readjust airway and try again. if still no rise then do 30 more compressions. if breathing by self, place in recovery position. If patient is a child you might have to kneel to reach belly.

Question 24

how to abdominal thrusts on infant

Answer 24

lay along forearm which is braced against knee or surface. Head is lower than legs. 5 back blows between shoulder blades, flip baby face up and deliver 5 chest compressions with 2 fingers just under nipple line. if unconscious, do 30 compressions

Question 25

if person is pregnant or obese and you need to do chest compressions

Answer 25

compress sternum

Question 26

what does an O2 concentrator do

Answer 26

converts air to pure oxgen

Question 27

what is a regulator

Answer 27

access compressed gas (gas in tank). flow meter controls flow rate of O2, which goes from 1/2 l/min to 15 l/min

Question 28

nasal cannula

Answer 28

used for stable (conscious) patients. lower flow rates of O2. 1/2-6. patient must be able to breathe through nose by themself

Question 29

venturi mask

Answer 29

delivers more precise amount of O2, between 24-50%. good for waning patients off of oxygen and patients with COPD

Question 30

nonrebreather mask

Answer 30

used for unstable patients. used for carbon monoxide poisoning. flow rate of 15, 90% )2. reservoir bag should be full if properly set.

Question 31

pulse oximeter

Answer 31

estimate of O2 saturation (O2 attached to hemoglobin of RBC). problems can occur with dark nails/nail polish, carbon monoxide poisoning, poor circulation, cold extremities, shaking.