Lonestar patient asm
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| What it the most frequent Airway Obstruction in the unconscious Patient? | show 🗑
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| What is Nasal Cavity's function? | show 🗑
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| show | A Muscular tube that extends vertically from the back of the soft palate to the superior aspect of the esophagus. Contains Epiglottis and Vallecula.
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| What is the Larynx? | show 🗑
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| What structures are in the Lower Airway? | show 🗑
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| show | At the Corina.
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| show | Bronchioles.
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| show | Connects the Larynx to the mainstem bronchi. Contains Catilaginous C-shaped open rings. Lined with epithelium containing cilia and mucous-producing cells.
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| show | The key functional unit of the respiratory system. Facilitates diffusion of oxygen and carbon dioxide.
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| show | Alveolar Collapse caused by insufficient surfactant or if the alveolar are not inflated. No gas exhcange takes place in atelectasis alveoli.
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| What is Parenchyma? | show 🗑
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| show | The visceral pleura envelopes the lungs and does not contain nerve fibers.
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| What is the Parietal Pleura? | show 🗑
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| show | Respiration is the exchange of gases between a living organism and its enviroment. Provides Oxygen to the cells and removes Carbon Dioxide.
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| show | Ventilation is the mechanical process that moves air in and out of the lungs. ( What we see and what we count)
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| What is Inhalation? | show 🗑
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| What is Exhalation? | show 🗑
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| What is Diffusion? | show 🗑
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| What are the four major respiratory gases? | show 🗑
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| show | Abbreviated Pa. Oxygen (PaO2) = 100 torr (average = 80-100)
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| show | Decreased Hemoglobin concentration. Inadequate alveolar ventilation. Decreased diffusion across the pulmonary membrane. Ventilation/perfusion mismatch occurs when a portion of the alveoli collapses.
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| show | Hyperventilation. Increased Carbon Dioxide production. Decreased Carbon Dioxide elimination.
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| show | Fever Muscle exertion Shivering Metabolic Processes
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| What is Hyperventialtions effect on concentraions in the blood? | show 🗑
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| show | Decreased Alveolar Ventialtion.
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| show | Collective group of control centers in the pons and medulla.
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| What groups are in the Medullary Rhythmicity area? | show 🗑
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| show | Integrates information from chemoreceptors for pCO2 and mechanoreceptros. Signals the VRG to alter the breathing rhythm.
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| show | Responsible for basic rhythm control. Normal, quiet breathing rhythm is generated by alternating patterns of stimulation and inhibition of motor neurons that signal the muscles of the diaphragm.
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| show | Limit respiratory duration by sending inhibitroy signals to the medullary rhythmicity area.
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| show | Located in Carotid Bodies, arch of the aorta, and the medulla.
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| How are chemorecptors stimulated? | show 🗑
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| What is the primary control of respiratory center stimulation? | show 🗑
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| What is the Herin-Breuer Reflex? | show 🗑
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| What is total lung capacity? | show 🗑
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| show | Average volume of gas inhaled or exhaledin one respiratory cycle. Approximately 500cc.
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| What are factors influencing respiratory rate? | show 🗑
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| What are the average respiratory rates for infants, children, and adults? | show 🗑
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| show | Amount of gas that reaches the alveolifor gas exchange in one minute.
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| What is Inspiratory Reserve Volume? | show 🗑
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| show | The amount of air that can be maximally exhaled after a normal expiration. Amount of gas that can be forcefully expired at the end of a normal expiration.
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| What is Dead Space? | show 🗑
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| What is Anatomic Dead Space? | show 🗑
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| What is Physiologic Dead Space? | show 🗑
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| show | The amount of gas in the tidal volume that reaches the alveoli for gas exchange. The Difference between Tidal Volume and Dead Space.
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| show | Alveolar Volume is the amount of air that does reach thealveoli for gas exchange (apporximately 350mL in an adult male) It is the difference between Tidal Volume and Dead Space.
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| What is Minute Volume? | show 🗑
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| show | The percentage of oxygen in inspired air.
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| show | The greatest rate of air flow that can be achieved during forced expiration beginning with the lungs fully inflated.
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| show | The amount of air remaining in the lungs at the end of maximal expiration. After a maximal forced exhalation, this is the amount of air remaining in the lungs and airway passages not able to be expelled.
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| What is Functional Residual Volume? | show 🗑
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| What is Forced Expiratory Volume? | show 🗑
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| What are some causes of respiratory problems? | show 🗑
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| What are Airflow Compromise Airway Sounds? | show 🗑
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| What are Gas Exchange Compromise Airway Sounds? | show 🗑
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| Pulse oximetry below what percentage is considered hypoxic? | show 🗑
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| What is the best technique for opening an airway on an unconscious patient? | show 🗑
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| What do airway adjuncts do? | show 🗑
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| What is the preferred advanced airway management method? | show 🗑
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| show | Layngoscope
Appropriate size Endotracheal Tube
10 mL syringe
Stylet
Bag-valve mask
Suction device
Bite block
Magill forceps
Tape or commercial securing device
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| What is Direct Laryngoscopy "DL"? | show 🗑
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| show | The blade is desgined to fit into the vallecula. When you lift its handle anteriorly, the blade elevates the tongue and, indirectly, the epiglottis, allowing you to see the glottic opening.
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| show | 0 for infants and 4 for large adults.
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| What is the placement for the Miller blade? | show 🗑
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| show | The Miller blade,because it stabilizes their floppier epiglottises and provides greater displacement of their relatively larger tongues.
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| What are Endotracheal Tubes? | show 🗑
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| What are Endotracheal Tube Components? | show 🗑
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| show | Are scissor- style clamps with circular tips. You will use them to remove foreign bodies or to redirect the endotracheal tube during nasotracheal intubation.
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| show | Isolates Trachea and permits complete control of airway Impedes gastric distention Eliminates need to maintain a mask seal Offers direct route for suctioning Permits administration of some medications.
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| What are some ET Intubation Indications? | show 🗑
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| What are some Complications of ET Intubation? | show 🗑
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| What are some disadvantages of ET Intubation? | show 🗑
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| show | Backwards Upward Rightward Pressure. Helps displace the glottis posteriorly allowing for a better visualization.
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| What does RSI (Rapid Seuence Induction) do? | show 🗑
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| show | Direct Laryngoscopy Esophageal Detction Device(EDD) Lack of epigastric sounds Bilateral breath sounds Condensation in the tube Colormetric Capnography ETCO2 capnography Lack of Phaonation No emesis in the tube Chest X-ray
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| show | Airway much smalle in diameter and shorter in length Infants tongue takes up more room Jaw is proportionally smaller Infants are nasal breathers Vocal cords higher ( C 2-3) and more anterior
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| What are pediatric anatomical differences? Continued | show 🗑
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| show | Use a resucitation tape (Broselow tape) Estimate using the diameter of the little finger Nare Diameter Formulas
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| show | Uncuffed = 4 + (age/4)
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| What is the formula for a pediatric cuffed tube? | show 🗑
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| show | How we trouble shoot resistance/problems. Displacement Obstruction - don't forget about secretions Pneumothorax Equipment
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| What are Nasotracheal Intubation Contraindications? | show 🗑
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| What is a "blind" procedure? | show 🗑
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| What are Nasotracheal Intubation Indications? | show 🗑
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| show | More difficult and time consuming Potentially more traumatic for patients Tube may kink or clog more easily Greater risk of infection Improper placement more likely Requires that patient be breathing
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| show | The head and neck can remain in neutral position It does not produce as much gag response and is better tolerate by the awake patient It can be secured more easily than an orotacheal tube The patient cannot bite the ET tube
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| show | The Patient is clearly able to maintain and protect his airway. The patient is not under the influence of sedatives. Reassessment indicates the problem that eld to endotracheal intubation is resolved.
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| show | PRovide alternate airway control Inseertion is rapid and easy Does not require visualization of the larynx Pharyngeal ballon anchors the airway Patient may be ventilated regardless of tube placement Gastric Content can be Suctioned Has trauma use
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| show | The cuff can caue esophageal, tracheal, and hypopharyngeal ischemia. It does not isolate and completely protect the trachea It cannot be used in patients with esophageal disease or caustic ingestions It cannot be used with pediatric
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| What are Esophageal Tracheal Combitube disadvantages? Continued | show 🗑
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| What is an Intubating Laryngeal Mask Airway? | show 🗑
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| show | Used for blind insertion, has an inflatable distal end that is placed in the hypopharynx and then inflated. Does not isolate Trachea however.
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| show | A supraglottic, single use , disposable airway that features a curve that replicates the natural human airway anatomy.
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| show | A supraglottic airway similar tot the laryngeal mask. "Cobra head" of the airway holds both of the soft tissue and the epiglottis out of the way.
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| show | Basic life support maneuvers should be attempted first. If these fail direct visualization of the airway for the foreign body removal is indicated.
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| What is a King LT Airway? | show 🗑
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| What are the two Surgical airways we can perform? | show 🗑
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| show | Only after all other airway skills have been tried.
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| What are Surgical Airway indications? | show 🗑
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| show | Inability to identify anatomical landmarks. Crush injury to the larynx Tracheal transection Underlying anatomical abnormalities
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| What is required to ventilate with a Needle Crocothyrotomy? | show 🗑
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| show | Barotrauma from overinflation Excessive bleeding due to improper catheter placement Subcutaneous Emphysema Airway obstruction Hypoventilation
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| show | Incorrect tube placement into a false passage Cricoid and/or thyroid catrilage damage Thyroid gland damage Severe bleeding Laryngeal nerve damage Subcutaneous emphysema Vocal cord damge Infection
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| What does Dificult Laryngoscopy mean? | show 🗑
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| show | Conventional laryngoscopy requires either A) more than three attempts or B) takes more than 10 minutes
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| What are factors related to difficult airways? | show 🗑
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| What does Difficult Airway mean? | show 🗑
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| show | Inability of unassisted paramedic to maintainan oxygen saturation of at least 90% using 100% oxygen and positive pressure mask ventilation or to not prevent or reveerse signs of inadequate ventilation during positive pressure mask ventilation.
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| show | Revised Cormack and LeHane POGO Mallampati
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| What is the Revised Cormack and LeHane classification? | show 🗑
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| show | The percentage of the glottis that can be visualized is scored.
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| What is Class 1 Mallampati score? | show 🗑
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| What is Class 2 Mallampati score? | show 🗑
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| What is Class 3 Mallampati score? | show 🗑
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| What is Class 4 Mallampati score? | show 🗑
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| show | Short neck Thick Neck Restricted range of motion Dentition Small Mouth Short Mandible Anterior Larynx Obesity Anatomical Distortion
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| What is LEMON? | show 🗑
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| How do you perform the Mallampati Score? | show 🗑
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| In LEMON what high risk factors do we look for? | show 🗑
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| show | Three of the patients fingers in their mouth "Normal mouth opening". Three fingers under the chin "Thyromental distance". Two fingers om the neck, Normal mandible anatomy- floor of the mouth to the thyroid cartilage.
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| show | Evaluate for stridor, foreign bodies, and other forms of sub/supra glottic obstruction.
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| show | Not assessed or pertinent in trauma patients. Patients with prior neck injuries, rheumatoid arthritis, severe osteoarthritis will be significantly harder to position.
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| show | Gastric Distention
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| show | Place head in neutral position Measure Tube Use topical anesthetic Lubricate and insert tube Encourage patient to swallow Advance to predetermined mark Verify placement Apply suction Secure in place
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| What are Gastric Distention and Decompression Indications? | show 🗑
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| show | Possibility of espohageal bleeding Increased risk of esophageal perforation
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| What does a small volume nebulizer do? | show 🗑
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| show | A tidal volume of at least 800mL of oxygen at 10 to 12 breaths per minute.
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| What does an effective artificial ventilation require? | show 🗑
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| What are the preffered Ventilation Methods in order? | show 🗑
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