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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| What is the Pharynx? | show 🗑
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| show | Joins the Pharnyx with the Trachea. Contains Catilage (Thyroid,Cricoid, and Arytenoid) Glottic Opening (Vocal Cords) Hyoid Bone
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| What structures are in the Lower Airway? | show 🗑
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| Where does the trachea divide into right and left mainstem bronchi? | show 🗑
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| What do the secondary and tertiary bronchi ultimately branch into? | show 🗑
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| What is the Trachea? | show 🗑
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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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| show | Principal or essential parts of an organ.
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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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| show | Under normal conditions does not require muscular effort; therefore a passive process. Diaphragm and intercostal muscles relax to make thorax smaller thus compresses air out the lungs.
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| show | Movement of a gas from an are of higher concentration to an area of lower concentration. Transfer gases between the lungs and the blood, and between the blood and the peripheral tissues.
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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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| What are Factors that affect oxygen concentration in the blood? | show 🗑
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| What are Factors affecting Carbon Dioxide concentrations in the blood? | show 🗑
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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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| What causes decreased Carbon Dioxide elimination? | show 🗑
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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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| What does the Dorsal Respiratory Group do? | show 🗑
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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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| Where are Chemoreceptors located? | show 🗑
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| show | Stimulated by decreased PaO2, increased PaO2, and decreased pH.
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| What is the primary control of respiratory center stimulation? | show 🗑
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| show | Prevent over inflation of the lungs in a conscious, spontaneously breathing person.
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| What is total lung capacity? | show 🗑
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| What is Tidal Volume? | show 🗑
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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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| What is Expiratory Reserve Volume? | show 🗑
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| What is Dead Space? | show 🗑
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| show | In the average adult man this equates to approximately 150 mL. Anatomic dead space includes airway passages such as the trachea and bronchi that are incapable of participating in gas exchange.
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| show | Physiologic dead space includes alveoli that have the potential to participate in gas exchange but do not because of disease or obstruction.
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| What is Alveolar Volume? | show 🗑
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| How is Alveolar Volume different than Dead Space? | show 🗑
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| What is Minute Volume? | show 🗑
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| What is FiO2? | show 🗑
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| What is Peak expiratory flow? | show 🗑
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| What is Residual Volume? | show 🗑
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| What is Functional Residual Volume? | show 🗑
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| show | The amount of air that can be maximally expired after maximum inspiration.
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| What are some causes of respiratory problems? | show 🗑
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| show | Snoring
Gurgling
Stridor
Wheezing
Quiet
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| show | Crackles
Rhonci
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| show | 85% or lower indicates severe hypoxia.
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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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| show | Generally Requires direct visualization of the larynx with a laryngoscope.
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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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| What sizes are the blades made? | show 🗑
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| What is the placement for the Miller blade? | show 🗑
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| Which Laryngoscope blade is preferred for children? | show 🗑
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| show | Flexible, translucent tube open at both ends and available in lengths ranging from 12 to 32 cm.
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| show | Pilot Ballon 15mm adapter Cuff
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| What are Magill Forceps? | show 🗑
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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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| show | Respiratory or cardiac arrest Unconsciousness Risk of aspiration Obstruction due to foreign bodies, trauma, burns, or anaphylaxis Respiratory extremis due to disease Pneumothorax, hemothorax, hemopneumothorax with respiratory difficulty.
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| What are some Complications of ET Intubation? | show 🗑
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| show | Requires considerable training and experience Requires specialized equipment Requires direct visualization of vocal cords Bypasses upper airway's functions of warming, filtering, and humidifying the inhaled air.
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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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| show | Children under 10 narrowest part of airway is cricoid cartilage Tracheal cartilage is softer and more collapsible Epiglottis is floppier and round. (Omega shaped) Vocal cords slant upward and are closer to the base of the tongue.
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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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| What is the formula for a pediatric uncuffed tube? | show 🗑
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| show | Cuffed = 3.5 +(age/4)
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| What is DOPE? | show 🗑
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| What are Nasotracheal Intubation Contraindications? | show 🗑
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| show | Procedures without direct visualization the vocal cords.
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| What are Nasotracheal Intubation Indications? | show 🗑
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| What are Nasotracheal Intubation Disadvantages? | show 🗑
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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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| What situations migh warrant Field Extubation? | show 🗑
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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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| What are Esophageal Tracheal Combitube disadvantages? | show 🗑
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| show | Suctioning tracheal secretions is impossible when the airway is in the esophagus Placing an endotracheal tube is very difficult with the ETC in place It cannot be used in conscious patients or in thos with a gag reflex
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| What is an Intubating Laryngeal Mask Airway? | show 🗑
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| What is a Laryngeal Mask Airway? | show 🗑
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| What is an Ambu Laryngeal Mask? | show 🗑
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| What is a Cobra Perilaryngeal Airway? | show 🗑
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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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| show | Alternative airway that stabilizes the airway at the base of the tongue. LArge silcone cuff that disperses pressure over a large mucousal surface area.
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| show | Needle Cricothyrotomy and a Surgical Cricothyrotomy
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| When should Surgical airways be used? | show 🗑
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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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| show | Transtracheal jet insufflation.
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| show | Barotrauma from overinflation Excessive bleeding due to improper catheter placement Subcutaneous Emphysema Airway obstruction Hypoventilation
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| What are Cricothyrotomy Complications? | show 🗑
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| What does Dificult Laryngoscopy mean? | show 🗑
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| What does Difficult Intubation mean? | show 🗑
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| What are factors related to difficult airways? | show 🗑
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| show | A conventionally trained paramedic experiences difficulty with mask ventillation, endotracheal intubation or both.
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| What does Difficult Mask Ventilation mean? | show 🗑
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| show | Revised Cormack and LeHane POGO Mallampati
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| show | Similar to the mallampati. Assigns four classes.
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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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| What are other Difficult Airway considerations? | show 🗑
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| What is LEMON? | show 🗑
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| show | - have the patient extend his neck, open his mouthfully and protrude his tongue and say "ah". Then Score the Class.
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| In LEMON what high risk factors do we look for? | show 🗑
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| What is the 3-3-2 rule? | show 🗑
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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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| What is the procedure for gastric distention and decompression? | show 🗑
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| show | The need for decompression because of the risk of aspiration or difficulty ventilating. Gastric Lavage in hypothermia and some overdose emergencies.
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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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| show | A patent airway An effective seal between the mask and the patients face Delivery of adequate volumes
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| show | Mouth-to-mouth Mouth-to-nose Mouth-to-mask Bag-valve device Demand Valve device Automatic transport ventilator
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