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EMS Airway Managmt
EMS Airway Management
| Question | Answer |
|---|---|
| The main structures / areas of Upper Airway | Nose Nasal Cavity Mouth Throat (Pharynx) Voice Box (Larynx) EMS works mostly in the Upper Airway |
| The main structures / areas of Lower Airway | Trachea Bronchi Bronchioles Alveoli |
| OPA / NPA | Plastic device to push to tongue away for the airway Oropharyngeal Airway Adjunct Nasopharyngeal Airway Adjunct |
| O S O | Primary Assessment - Airway The A in ABCDE Open Suction OPA/NPA |
| Head Tilt / Chin Lift Maneuver | Maneuver used to open the airway Hand on forehead pressing down Fingers under the chin pulling chin up. Rotates head back and raises the chin Not used when spinal injury is suspected |
| The most common occlusion of the airway is... | The Tongue The tongue muscle relaxes along with other muscles and gravity pulls it into the back of the pharynx. |
| Head-Tilt / Chin-lift | Tilt head back and lift their chin Lifts the tongue Not good for potential spinal injuries! |
| Jaw-Thrust | Head neck kept neutral Mandible is moved forward and up Use 2 hands - one on each side of jaw Better used with potential spinal injuries |
| Patent Airway | Patient is able to open their own airway and breathe Patient is talking |
| Crossed-Finger Method | A method to open the mouth. Used when suction is needed but you don't want it going down first |
| 3 methods to clean an airway | Gravity - log roll Finger Sweep Suction |
| Rules for Suctioning | Don’t insert further than you can see Insert catheter without suction Suction no more than 10-15 seconds (adult) and 5-10 (child) Repeat if needed |
| OPA | Oropharyngeal Airway Adjunct Plastic device inserted into the mouth to push to tongue away for the airway |
| OPA Insertion (Adult) | S - size - mouth to angle of the jaw I - Insert upside down, hit pallet and twist 180 C - check for gagging |
| NPA Insertion (Adult) | SLIC S - Size L - Lube I - Insert - bevel side toward septum C - can you see it |
| NPA | Nasopharyngeal Airway Adjunct Plastic device inserted into the nose to push to tongue away for the airway |
| Septum | Dividing membrane between the two nostrils |
| Adjunct | A thing added to something else as a supplementary rather than an essential part. NPA and OPA are Airway Adjuncts. |
| COPD | Chronic Obstructive Pulmonary Disease A type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. There are 2 types Everyday activities such as walking or dressing becoming difficult. |
| Tachypnea | Fast breathing Faster than normal |
| Bradypnea | Slow breathing Slower than normal |
| Tripod position | A position a person who is experiencing respiratory distress may take to help relieve their distress. seated while leaning forward with their arms resting on their knees or stands with their arms resting on another surface such as a table |
| Breathing Assessment (terms to describe) | Rate - times / min Rhythm - regular / irregular Quality - normal, shallow, labored, noisy Depth - full and equal |
| Signs of respiratory difficulty | Tachypnea – fast Bradypnea – slow Cyanosis Nasal Flaring Tripod position Changes in mental status |
| The organ that divides the upper from lower airway | Epiglottis |
| Apnea | Not breathing Transient or permanent cessation of respiration |
| Agonal Breathing | Reflexive irregular, gasping breaths often seen during cardiac arrest Do not provide oxygen. Consider this the same as not breathing. Looks like fish out of water breathing |
| Congestive Heart Failure (CHF) | Heart is not pumping well resulting in fluid backing up resulting in other conditions. Causes difficulty breathing, leg swelling, tiredness |
| Bronchitis | Inflammation of the bronchi (large and medium-sized airways) in the lungs that causes coughing. Type types: Acute or Chronic |
| Asthma | A long-term inflammatory disease of the airways of the lungs characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. |
| Bronchospasm or Bronchial Spasm | a sudden constriction of the muscles in the walls of the bronchioles caused by several conditions Bronchospasms can occur in asthma, chronic bronchitis and anaphylaxis. |
| Emphysema | One type of COPD A lower respiratory tract disease, characterized by air-filled spaces (pneumatoses) in the lungs. Brittle alveoli break and merge. |
| Pneumothorax | Occurs when air leaks into the space between your lung and chest wall. Air pushes on the outside of your lung and makes it collapse/shrink collapsed lung |
| Diaphragm spasm | involuntary contractions of the band of muscle that divides the upper abdomen and chest may feel like a twitch or flutter and can occur with or without pain. |
| Albuterol | A short acting prescription medication that opens up the medium and large airways in the lungs. Typically administered via an inhaler. Used for asthma, bronchoconstriction, and COPD |
| Nasal Cannula | a device used to deliver supplemental oxygen consists of a lightweight tube which on one end splits into two prongs which are placed in the nostrils and from which a mixture of air and o |
| Nasal Flaring | occurs when your nostrils widen while breathing may be a sign of breathing difficulty . Most commonly seen in children and infants. In some cases, it can indicate respiratory distress. |
| Cyanosis | a bluish discoloration of the skin resulting from poor circulation or inadequate oxygenation of the blood. |
| What drives respiration | Normal respiration is driven by CO2 lower pH will drive more respiration |
| Principles of Suction | Only suction what you can see 10-15 secs for adult 5-10 secs for child Don't go down further than you can see |
| Airway Treatments (list) | Open airway and keep clear Position to make breathing easier Supplemental Oxygen (SaO2 <94%) Inhaler |
| Stridor | Lung sound A special type of Wheeze which is a harsh, high-pitched, vibrating sound that is heard in respiratory tract obstructions. |
| Wheeze | Lung sound A continuous, coarse, whistling sound produced in the respiratory airways during breathing. some part of the respiratory tree must have narrowed or become obstructed |
| Alveoli | hollow, distensible cup-shaped cavities in the lungs where oxygen is exchanged for carbon dioxide aka Air Sac |
| Nebulizer | a drug delivery device used to administer medication in the form of a mist inhaled into the lungs. |
| Hypoxic Drive | A form of respiratory drive in which the body uses O2 chemoreceptors instead of CO2 receptors to regulate the respiratory cycle. Caused by chronic high CO2 levels |
| Hypercapnia | A condition of abnormally elevated carbon dioxide (CO2) levels in the blood. Latin: Too much smoke |
| Hypoventilation | occurs when ventilation is inadequate to perform the needed respiratory gas exchange. Not the same as Ventilation Arrest |
| Hyperventilation | irregular breathing that occurs when the rate or tidal volume of breathing eliminates more carbon dioxide than the body can produce. |
| Control of Ventilation | The primary drive is the level of CO2 in the blood. Higher CO2 levels lower the pH and increase the ventilation rate. |
| Hypoxia | A condition in which the BODY or a REGION OF THE BODY is deprived of adequate oxygen supply at the tissue level. Different from Hypoxemia Hint: Hypoxemia can result in Hypoxia |
| Hypoxemia | An abnormally low level of oxygen in arterial BLOOD. Different than Hypoxia Hint: Hypoxemia can result in Hypoxia |
| Anoxia | An extreme form of Hypoxia in which there is complete deprivation of oxygen supply. |
| Respiration vs Ventilation | Ventilation is mechanical and involves the movement of air Respiration is physiologic and involves the exchange of gases in the alveoli and in the cells . Ventilation allows for Respiration |
| Ventilation | Breathing The physical movement of air in and out of the lungs. Two phases: inspiration and expiration (inhale/exhale) What ventilator do. |
| Respiration | The movement of gas across a membrane. Without ventilation, respiration cannot occur. |
| Expiration | to exhale One of the two phases of ventilation |
| Inspiration | to inhale One of the two phases of ventilation |
| Rales | Lung sound Fine cracking sounds. Indicated fluids in the lungs |
| Acute Bronchitis | A short term inflammation of the bronchi of the lungs. also known as a chest cold, |
| Chronic Bronchitis | a lower respiratory tract disease, defined by a productive cough that lasts for three months or more per year for at least two years. |
| Respiratory Arrest | respiratory dysfunction severe enough it will not sustain the body (such as agonal breathing). |
| Pharynx | The throat connects the mouth and nose to the esophagus |
| NPA / OPA | NPA - Nostril to inferior tip of the ear OPA - Corner of mouth to inferior tip of the ear |
| Hypercapnic Drive | The normal primary driving regulator for respiration rate. Higher CO2 levels in the blood increase breathing rate and the need to breath (breath holding). The backup system is the Hypoxic Drive |
| Hypoxic Drive vs Hypercapnic Drive | Normal is Hypercapnic Drive. High CO2 drives respiration rate. Chronic high CO2 levels can cause hypercapnic drive to fail. The back up system is Hypoxic Drive (low O2 drives). |
| NPA Indications | Respiratory distress in upper airway when airway maintenance is necessary and an OPA or advanced airway is not tolerated. May be needed for patients that are unconscious but clenching their jaw. |
| OPA Indications | patient is at risk of airway obstruction due to relaxed upper airway muscles or blockage of the airway by the tongue. |
| O2 Flow Rates for each Respiration Device | Cannula: 2-6 plm Non Rebreather: 10-15 lpm BVM: 15+ lpm |
| Cannula (nasal) | a flexible tube, usually with multiple short, open-ended branches for comfortable insertion into the nostrils and/or mouth, and may be used for the delivery of a gas (such as pure oxygen) Means: little reed |
Created by:
danfar
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