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BURP maneuver | Backward, upward, rightward pressure used during intubation to improve the laryngoscopic view of the glottic opening. Also called external laryngeal manipulation. |
Challenges in ET Intubation | 3-3-2 rule - A mouth opening less then three fingers wide, a mandible length of less than three fingers wide, and a distance from the hyoid bone to thyroid notch of less than two fingers wide indicate a possible difficult airway. |
Auto Transport Ventilator | ATV A portable mechanical ventilator attached to a control box that allows the variables of ventilation to be set. (rate and tidal volume) |
Chemoreceptors | Sense organs that monitor the levels of oxygen and carbon dioxide and the PH of the CSF and the blood and provide feedback to the respiratory centers to modify the rate and depth of breathing based on the body's need at any given time. |
Combitube | A multilumen airway device that consists of a single tube with two lumens, two balloons, and two ventilation ports; an alternative device if endotracheal intubation is not possible. |
What is COPD | Chronic obstructive pulmonary disease. Emphysema and chronic bronchitis. |
What is COPD presentation | They always have a higher blood levels of carbon dioxide. |
Cor Pulmonale | Cor pulmonale is a condition that causes the right side of the heart to fail. Long-term high blood pressure in the arteries of the lung and right ventricle of the heart can lead to cor pulmonale |
Cough | Glottic opening closes tight to trap air in lungs, abdomen and thoracic muscles contract pushing against diaphragm and increase pressure in tracheobronchial tree. Vocal cords suddenly open and force air and foreign particles out. |
CPAP reassessment | reassess the patient for signs of clinical deterioration and/or respiratory failure. |
Direct visual larngoscopy | Visualization of the airway with a laryngoscope. |
Drug OD's that suppress breathing | |
Parts of the ET Tube | proximal end, the tube, the cuff, pilot balloon and the distal tip. |
Insertion depth/gauge of ET tube | Insert until resistance is met, then withdraw a few centimeters |
ET Tube sizes | 2.5 to 9.0 in inside diameter and length ranges from 12 to 32 cm. woman 7.0 to 8.0. men 7.5 to 8.0. |
King LT airway | is a single-lumen airway that is blindly inserted into the esophagus |
Laryngospasm | Spasmodic closure of vocal cords |
LMA | Laryngeal Mask Airway. Is designed to provide a conduit from the glottic opening to the veneration device. It surrounds the opening of the larynx with an inflatable silicone cuff. |
MDI use | a pressurized canister that delivers a specific dose of a medication, commonly used for beta-agonist bronchodilators. |
Minute volume | The volume of air moved through the lungs in one minute minus the dead space; calculated by multiplying total volume (minus dead space) and respiratory rate. |
Mucus | |
Oropharyngeal airway | Oral airway. A hard plastic device that is curved so that it fits over the back of the tongue with the tip in the posterior pharynx |
Nassopharyngeal (nasal) airway | A soft rubber tube about 6 inches long that is inserted through the nose into the posterior pharynx behind the tongue, thereby allowing passage of air from the nose to the lower airway. |
Orthopnea | Positional dyspnea |
Oxygen | 100% pure oxygen is stored in seamless steel or aluminum cylinders. Make sure labeled medical oxygen. Also look for a series of letters and numbers on the collar. |
Oxygen Regulators | High pressure regulators are attached to the cylinder stem to deliver gas under pressure. These are used to transfer gas from tank to tank. Therapy regulator attaches to the stem and reduces the pressure to a safe level 50psi. |
Peak expiratory flow | An approximation of the extent of broncho-constriction; used to determine weather therapy such as with inhaled bronchodilators is effective. |
Pickwickian syndrome | Obesity hypoventilation syndrome; respiratory compromise related to morbid obesity. |
Pneumonia | An inflammation of the lungs caused by bacterial, viral or fungal infections |
Pneumothorax | Collapsed lung. A build up of air between the lung and the chest wall. |
What is a bronchodilator | A bronchodilator is a substance that dilates the bronchi and bronchioles, decreasing resistance in the respiratory airway and increasing airflow to lungs. |
What is a venturi mask | A mask with a number of interchangeable adaptors that draw room air into the mask along with oxygen flow. |
Vallecula | An anatomic space or pocket located between the base of the tongue and the epiglottis. |
Respiratory acidosis | Decreased PH - increased carbon dioxide levels |
Respiratory alkalosis | Increased PH - decreased carbon dioxide levels |
Positive ventilation | Is the forcing of air into lungs and is provided via bag-mask device, pocket mask, or mechanical ventilation device to patients whom are not breathing. |
Negative ventilation | Is the drawing of air into the lungs due to changes in intrathoracic pressure. |
Anatomy for cricothyroid procedure | The superior cricothyroid vessels run at a transverse angle across the upper third of the cricothyroid membrane. The external jugular veins run vertically and are located lateral to the cricothyroid membrane. Thyroid cartilage, cricoid cartilage, trachea, |
Ventilation | The physical act of moving air into and out of the lungs. |
Oxygenation | The process of loading oxygen molecules onto hemoglobin molecules in the bloodstream. |
Respiration | The actual exchange of oxygen and carbon dioxide in the Alveoli and the tissues of the body. |
Anatomy of upper airway | All structures above the vocal cords; larynx, oropharynx, nasopharynx, and tongue. |
Anatomy of lower airway | All structures below the vocal cords; trachea, mainstream bronchi, bronchioles, pulmonary capillaries, and Alveoli. |
Assessment findings of a COPD patient | |
Combitube | A multilumen airway device that consist of a single tube with two lumens, two balloon, and two ventilation ports; an alternative devise if the endotracheal inhibition is not possible or has failed. |
ETC02 -readings - waveforms | end-tidal co2 monitors detect presence of carbon dioxide in exhaled air and are important adjuncts for determining ventilation adequacy. |
FROPVD | flow-restricted, oxygen-powered ventilation device (FROPVD), also referred to as a manually triggered ventilation device (MTV), is used to assist ventilation in apneic or hypoventilatig patients. |
History of respiratory patient | |
Hyperventilation | A condition in which an increased amount of air enters the Alveoli; carbon dioxide elimination exceeds carbon dioxide production |
Hypoventilation | A condition in which a decreased amount of air enters the Alveoli; carbon dioxide production exceeds the body's ability to eliminate it by ventilation. |
Pressure-compensated flowmeter | Incorporates a float ball within a tapered calibrated tube; this float rises or falls based on the gas flow in the tube. (Must remain in an upright position. |
nervous control centers of respiration/ventilation | |
bourdon-gauge flowmeter | is not affected by gravity and can be placed in any position. the major disadvantage is that it does not compensate for backpressure, as a result it will usually record a higher flow rate when there is any obstruction to gas flow downstream. |
Pulse oximeter | measures the percentage of blood that is saturated with oxygen. this type of measurement depends on adequate perfusion to the capillary beds and can be inaccurate when patient is cold, in shock or has be exposed to carbon monoxide. |
preoxygenation prior to advanced airway procedure | Preoxygenate with 100% O₂ and hyperinflate for 30 seconds. Preoxygenate to prevent hypoxemia
• Hyperinflate to prevent atalectasis |
stethoscope parts and uses | |
stoma | skill drill 14, 15 and 16. page 770 In the context of the airway, the resultant orifice of a tracheostomy that connects the trachea to the outside air; ,
located in the midline of the anterior part of the neck. |
trach tubes | page 770 and 771 |
suction tips time technique | The application of negative pressure (vacuum) to the airways through a collecting tube. Proper technique
• Adequate oxygenation and ventilation before and after
• Strict adherence to time limits. DONT DO IT IF YOU DONT HAVE TO..... |
open airway - manual techniques | Head-Tilt Chin-lift is a manual airway maneuver that involves tilting the head back while lifting up on the chin; used to open the airway of an unresponsive nontrauma patient. |
open airway - manual techniques | Jaw-Thrust Maneuver; A technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used when a patient may have a cervical spine injury. |