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Chapter 9

Airway Management

aerobic metabolism metabolism that can proceed only in the presence of oxygen
agonal gasps occasional, gasping breaths that occur after the heart has stopped
airway the upper airway tract or the passage above the larynx, which includes the nose, mouth, and throat
alveolar ventilation the volume of air that reaches the alveoli. It is determined by subtracting the amount of dead space air from the tidal volume.
American Standard System A safety system for large oxygen cylinders, designed to prevent the accidental attachment of a regulator to a cylinder containing the wrong type of gas.
anaerobic metabolism the metabolism that take place in the absence of oxygen; the principle product is lactic acid
apnea absence of spontaneous breathing
aspiration in the context of airway, the introduction of vomitus or other foreign material in the lungs
ataxic respirations irregular, ineffective respirations that may that may or may not have an identifiable pattern
automatic transport ventilator (ATV) a ventilation device attached to be a control box that allows the variables of ventilation to be set. It frees the EMT to perform other tasks while the patient is being ventilated.
bag-mask device a device with a one-way valve and a face mask attached to a ventilation bag; when attached to a reservoir and connected to oxygen, delivers more than 90% supplemental oxygen.
barrier device a protective item, such as a pocket mask with a valve, that limits exposure to a patient's body fluids.
bilateral a body part or condition that appears on both sides of the midline.
bronchioles subdivision of the smaller bronchi in the lungs; made of smooth muscle and dilate or constrict in response to various stimuli.
carina point at which the trachea bifurcates (divides)into the left and right mainstem bronchi.
chemoreceptors monitor the levels of 02, C02, and pH of the cerebrospinal fluid and then provide feedback to the respiratory centers to modify the rate and depth of breathing based on the body's needs at any given time
compliance the ability of the alveoli to expand when air is drawn in during inhalation.
continuous positive airway pressure (CPAP) a method of ventilation used primarily in treatment of critically ill patients with respiratory distress; can prevent the need for endotracheal intubation
dead space the portion of the tidal volume that does not reach the alveoli and thus does not participate in gas exchange.
diffusion a process in which molecules move from an area of higher concentration to an area of lower concentration.
dyspnea shortness of breath
exhalation the passive part of the breathing process in which the diaphragm and the intercostal muscles relax, forcing air out of the lungs.
external respiration the exchange of gases between the lungs and the blood cells in the pulmonary capillaries; also called pulmonary respiration.
gag reflex a normal reflex mechanism that causes retching; activated by touching the soft palate or the back of the throat.
gastric distention a condition in which air fills the stomach, often as a result of high volume and pressure during artificial ventilation.
glottis the space in between the voal cords that is the narrowest portion of the adult's airway; also called the glottic opening.
good air exchange a term used to distinguish the degree of distress in a patient with a mild airway obstruction. With good air exchange,the patient is still conscious and able to cough forcefully. although wheezing may be heard.
head tilt-chin lift maneuver a combination of two movements to open the airway by tilting the forehead back and lifting the chin; not used for trauma patients.
hypercarbia increased carbon dioxide level in the blood stream.
hypoxia a dangerous condition in which the body tissues and cells do not have enough oxygen
hypoxic drive a condition in which chronically low levels of oxygen in the blood stimulate the respiratory drive; seen in patients with chronic lung diseases.
inhalation the active, muscular part of breathing that draws air into the airways and lungs.
internal respiration the exchange of gases between the blood cells and tissues.
intrapulmonary shunting bypassing of oxygen-poor blood past nonfunctional alveoli to the left side of the heart.
jaw-thrusting maneuver technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used for patients who may have a cervical spine injury.
labored breathing breathing that requires greater than normal effort; may be slower or faster than normal and usually requires the use of accessory muscles.
larynx a complex structure formed by many independent cartilaginous structures that all work together; where the upper airway ends and the lower airway begins; also called the voice box.
manually triggered ventilation device a fixed flow/rate ventilation device that delivers a breath every time a button is pushed; also referred to as a flow-restricted, oxygen power ventilation device.
mediastinum space within the chest that contains the heart, major blood vessels, vagus nerve, trachea, major bronchi, and esophagus; located between the two lungs.
metabolism (cellular respiration) the biochemical processes that result in production of energy from nutrients within the cells.
mild airway obstruction occurs when a foreign body partially obstructs the patients airway. the patient is able to move adequate amounts of air, but also experiences some degree of respiratory stress.
minute ventilation the volume of air moved through the lungs in one minute minus the dead space; calculated by multiplying tidal volume (minus dead space) and respiratory rate; also referred to as minute volume
nasal cannula an oxygen-delivery device in which oxygen flows through two small, tubelike prongs that fit into the patients nostrils; delivers 24% to 44% supplemental oxygen, depending on the flow rate.
nasopharynx the nasal cavity; formed by the union of facial bones and protects the respiratory tract from contaminants
nasopharyngeal (nasal) airway airway adjunct inserted into the nostril of an unresponsive patient, or a patient with an altered level of conciousness who in unable to maintain airway patency independently.
nonrebreathing mask a combination mask and reservoir bag system that is the preferred way to give oxygen in the prehospital setting; delivers up to 90% inspired oxygen and prevents inhaling the exhaled gases (carbon dioxide).
oropharyngeal (oral) airway airway adjunct inserted into the mouth from an unresponsive patient to keep the tongue from blocking the upper airway and to facilitate suctioning the airway, if necessary.
oropharynx forms the posterior portion of the oral cavity, which is bordered superiorly by the hand and soft palates, laterally by the cheeks, and inferiorly by the tongue.
oxygenation the process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs.
parietal pleura thin membrane that lines the chest cavity
partial pressure the term used to describe the amount of gas in air or dissolved in fluid such as blood.
patent open, clear of obstruction.
phrenic nerve nerve that innervates the diaphragm; necessary for adequate breathing to occur.
pin-indexing system a system established for portable cylinders to ensure that a regulator is not connected to a cylinder containing the wrong type of gas.
pneumothorax a partial or complete accumulation of air in the pleural space.
poor air exchange a term used to describe the degree of distress in a patient with a mild airway obstruction. With poor air exchange, the patient often has a weak, ineffective cough, increased difficulty breathing, or possible cyanosis, may produce a high-pitched stridor
Created by: lharbridge