AEMT Chapter 11 - Airway Management

Acidosis

Accumulation of acids in the body

Airway

The passage above the larynx which includes the nose, mouth, and throat. The lower airway includes the trachea and lungs.

Alkalosis

The buildup of of excess base (lack of acids) in the body

Anoxia

Absence of oxygen

Apnea

Absence of breathing; periods of not breathing

Aspiration

Breathing fluid, food, vomitus, or an object into the lungs

Asymmetric chest wall movement

Unequal movement of the two sides of the chest; indicates decreased airflow into one lung.

Atelectasis

condition in which lung tissue collapses, that causes pulmonary shunting, ventilation-perfusion mismatching, and possibly hypoxemia

Automatic transport ventilator

A device that provides positive pressure ventilations. It includes settings designed to adjust ventilation rate and volume, is portable, and is easily carried on an ambulance.

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, it 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.

Bilevel positive airway pressure (BiPAP)

noninvasive ventilation device like a CPAP machine; however, it can be set at a higher pressure for inhaling and a lower pressure for exhaling.

Bourdon gauge flowmeter

An oxygen flowmeter that is commonly used because it is not affected by gravity and can be placed in any position.

Bradypnea

slow respiratory rate, usually below 10 respirations per minute

Bronchioles

Airways in the lungs that lead from the bronchi to the alveoli.

Capnographer

A device that attaches between the endotracheal tube and bag-mask device; provides graphic information about the presence of exhaled CO2 .

Carina

Point at which the trachea bifurcates (divides) into the left and right mainstem bronchi.

Cellular respiration

Process that releases energy by breaking down glucose and other food molecules in the presence of oxygen to the form of adenosine triphosphate (ATP)

Cobra perilaryngeal airway (CobraPLA)

A supraglottic airway device with a shape that allows the device to slide easily along the hard palate and to hold the soft tissue away from the laryngeal inlet.

Combitube

A multilumen airway device that consists of a single tube with two lumens, two balloons, and two ventilation ports; an alternative airway device if endotracheal intubation is not possible or has failed. Provides ventilation of the patient whether the tube is inserted into the esophagus or trachea.

Continuous positive airway pressure (CPAP)

A method of ventilation used primarily in the 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.

Dorsal respiratory group

A portion of the medulla oblongata where the primary respiratory pacemaker is found.

Dyspnea

Shortness of breath or difficulty breathing.

Exhalation

the part of the breathing process in which the diaphragm and the intercostal muscles relax, forcing air out the lungs

Delete

Hering-Breuer reflex

A protective mechanism that terminates inhalation, thus preventing overexpansion of the lungs.

Hypercapnia

excessive carbon dioxide in the blood

Hyperventilation

an increased amount of air entering the alveoli, which lowers the blood carbon dioxide level and usually is a result of rapid breathing

hypoxia

A dangerous condition in which the body tissues and cells do not have enough oxygen.

hypoxic drive

A "backup system" to control respiration; senses drops in the oxygen level in the blood.

I-gel

A supraglottic airway device that uses a non-inflatable, gel-like mask to isolate the larynx and facilitate ventilation.

inhalation

the act of taking in air as the diaphragm contracts and pulls downward

Inspiration

the process of moving air into the lungs

Ketoacidosis

an acid-base imbalance caused by an increase in concentration of ketones in the blood

King LT airway

A single-lumen airway that is blindly inserted into the esophagus; when properly placed in the esophagus, one cuff seals the esophagus, and the other seals the oropharynx.

Laryngeal Mask Airway (LMA)

A device that surrounds the opening of the larynx with an inflatable silicone cuff positioned in the hypopharynx; an alternative device to bag-mask ventilation.

Laryngospasm

the sudden spasmodic closure of the larynx

Larynx

A region in the throat that contains the epiglottis, thyroid cartilage, cricoid cartilage, voice box

Mediastinum

area between the lungs containing the heart, aorta, venae cavae, esophagus, and trachea

Negative pressure ventilation

Drawing of air into the lungs; airflow from a region of higher pressure (outside the body) to a region of lower pressure (the lungs); occurs during normal (unassisted breathing).

Oropharyngeal airway

Airway adjunct inserted into the mouth of an unresponsive patient to keep the tongue from blocking the upper airway and to facilitate suctioning the airway, if necessary.

Orthopnea

ability to breathe only in an upright position

Paradoxical motion

The motion of the portion of the chest wall that is detached in a flail chest; the motion—in during inhalation, out during exhalation—is exactly the opposite of normal chest wall motion during breathing.

Parietal pleura

lines the walls of the thoracic cavity

Partial pressure

Amount of gas in air or dissolved in fluid, such as blood

Partial rebreathing mask

A mask similar to the nonrebreathing mask but without a one-way valve between the mask and the reservoir; room air is not drawn in with inspiration; residual expired air is mixed in the mask and rebreathed.

Patent

open and clear; free from obstruction

Pulmonary edema

fluid in the lungs; usually a result of congestive heart failure

Pulse oximetry

An assessment tool that measures oxygen saturation of hemoglobin in the capillary beds.

Recovery position

A side-lying position used to maintain a clear airway in unconscious patients without injuries who are breathing adequately.

Residual volume

Amount of air remaining in the lungs after a forced exhalation

Respiratory acidosis

A drop in blood pH due to hypoventilation (too little breathing) and a resulting accumulation of Co2.

Respiratory alkalosis

Arise in blood pH due to hyperventilation (excessive breathing) and a resulting decrease in CO2.

Respiratory rate

number of breaths per minute

Stridor

strained, high-pitched sound heard on inspiration caused by obstruction in the pharynx or larynx

Surfactant

chemical produced in the lungs to maintain the surface tension of the alveoli and keep them from collapsing

Tachypnea

rapid breathing

Tidal volume

Amount of air that moves in and out of the lungs during a normal breath

Turbinates

Bones that protrude into the nasal cavity- they increase surface area for filtering dust and dirt particles by the mucous membrane.

Visceral pleura

the inner layer of pleura that surrounds each lung

Vital capacity

The total volume of air that can be exhaled after maximal inhalation.

Wheezing

High pitched sound heard in the lungs with asthmatics or lung disease or suggests an obstruction or narrowing of the lower airways. Most prominent on expiration

External respiration

Exchange of oxygen and carbon dioxide between alveoli and blood in pulmonary capillaries

Internal respiration

Exchange of oxygen and carbon dioxide between systemic circulatory system and cells of the body

The suction rule 5-10-15 applies to?

5 secs- Infants
10 secs - Children
15 secs - Adults

During insertion of an oropharyngeal airway into an unconscious patient, she begins to vomit. What should you do?

Turn the patient on their side, remove the airway, and suction

FiO2 for NC

24-44%

FiO2 for SFM

35-55%

FiO2 for NRBM

60-95%

FiO2 for BVM

90-95%

PEEP stands for

Positive End Expiratory Pressure

Ventilation

Physical act of moving air into and out of lungs

Oxygenation

Process of loading oxygen molecules onto hemoglobin molecules in the blood stream

Delete

Where does the upper and lower airway seperate

Glottic opening