airway/respiratory

if you have a patient who is unconscious, you may need to suction your patient because…

secretions may have settled in the hypo-pharynx even if you do not hear any gurgling sounds

two ways to open a patient’s airway

jaw-thrust maneuver or head tilt/chin maneuver

to open the airway of an infant or young child,

apply gentle and conservative extension of the head and neck

a nosey airway means

something is partially obstructing the airway

snoring occurs when

the tongue is partially blocking the airway

gurgling indicates

that fluid (like blood), secretions and/or gastric content is blocking the airway

what is stridor?

high pitched inspiratory screech. life threatening upper airway problem if not treated

what can cause stridor?

foreign body, serve swelling, allergic reaction and/or infections

if stridor is being caused by a foreign object in the airway, what do you do?

abdominal thrust for anyone over the age of 1. if under one, then back blows and chest thrust. if this does not work, then you may have to use Magill Forceps to remove the object

blank respiratory infections such as croup or epiglottitis

upper

what is the treatment for croup?

vaporized epinephrine, CPAP, BiPAP, intubation or cricothyrotomy

respiratory burns can cause

rapid massive swelling or the upper airway and requires endotracheal intubation

what is the treatment for anaphylaxis?

vasoconstrictor medication to decrease the upper airway swelling

common causes of stridor

epiglottitis, respiratory burns and anaphylaxis

s/s of epiglottitis

fever, illness, drooling ,sore throat, hoarse and/or inability to swallow

what causes wheezing?

constricted bronchioles

what can cause wheezes?

asthma, bronchitis, emphysema, acute pulmonary edema and/or bronchospasm

bronchiolitis is a blank respiratory infection

lower

a patient who has a pulse but is not moving air is said to be in what?

respiratory arrest

treatment for someone in respiratory arrest

ventilation with a BVM and oxygen

your patient has a neck lac. you see bubbles coming from the neck lac indicating what

air is escaping from damage tissue from the lac causing subcutaneous emphysema. treatment would be an occlusive dressing taped on three sides

if your patient is unconscious and does not have a gag reflex insert a…

opa

if your patient is unconscious and has a gag reflex insert a…

npa

abnormally fast or slow breathing patterns actually

decrease the amount of air that reaches the alveoli for gas exchange

if you have a patient who is breathing really fast OR really slow, this could be an indication of

the body is attempting to rid itself of excess acids. kinda like a compensatory mechanisms

abnormal respiratory patterns can indicate a

diabetic, severe acidosis and/or head injury problem

what is Kussmaul’s respiratory?

deep, consistent breathing. somewhat fast. it’s the body’s response to metabolic acidosis (when the bidy has too much acid)

when would you see someone having a Kussmaul breathing?

metabolic acidosis… examples would be DKA, kidney failure, severe infections like sepsis

what is Cheyne-Stokes respirations?

deep, rapid breathing then a pause. mouth is usually open because the muscles in the jaw are relaxed

when would someone have Cheyne-Stokes respiration?

What is Biot’s respiration?

all over the place. will be fast, then slow then stop then go back to fast

what’s what difference between Cheyne-Stokes and Biot’s Respiration?

Cheyne-Stroke is fast, slow then stops and contiunes in this same pattern. Irregular but does have a pattern.

Biot’s is ALL over the past, fast, slow, stop then maybe fast again but then stops. Irregular but does not have a pattern.

Why would someone have Biot’s respiration?

what is acute pulmonary edema?

fluid in the lungs usually caused by a heart condition like CHF

Treatment for someone with pulmonary edema?

CPAP and nitroglycerin. the CPAP helps keep the airways open especially during exhalation when they tend to collapse

what is tension pneumothorax?

absent breath sounds on one side and diminished breath sounds on the other side. the air can’t leave the pleural space making it tension rather than just normal pneumothorax

s/s of tension pneumothorax?

shortness of breath, chest pain, low SPO2, low BP and high heart rate

treatment for someone with tension pneumothorax?

needle decompression on the affected side to release the air

what is flail segment?

life-threatening condition that happens when three or more rib fractures in two places causing the chest wall to move separate and independent

treatment of flail segment

BVM ventilation and oxygen

what is paradoxical movement?

a segment of the chest moves inward during inhalation while the rest of the chest expands

what is respiratory rate?

number of times a person breaths in one minute

tachypnea can be the result of

hypoxia, shock, head injury or anxiety

bradypnea can be the result of

drug overdose, severe hypoxia and/or any issue to the CNS (TBI, stroke, infections)

the lungs supply the arteries with blank

oxygen

what is respiratory effort?

how hard the patient is working to breathe

normal inhalation is an blank process that requires blank

active, energy

exhalation is a blank process

passive

what is quality of respiration?

depth and pattern of breathing

depth or tidal volume is

the amount of air the patient moves in and out of the lungs in one breath

what are rales/crackles?

light crackling, popping sounds usually heard during inspiration. they are produced by air passing through moisture in the bronchoalveolar system OR from the abrupt opening of the closed airway

what are coarse crackles/rales?

loud, low pitched and long similar to the sound of water boiling. normally audible at the mouth

what are fine crackles/rales?

soft, high-pitched and very brief. kinda sound like rice krispies crackling

what is rhonchi?

continuous sounds with a lower pitched and snoring quality. caused by secretions in the larger airways. common in bronchitis and pneumonia

what are pleural friction rubs?

squeaking or grating sounds of the pleural layers are inflamed and have lost their lubrication. kinda sounds like sandpaper. would hear it in a PE and/or pneumonia

pink, frothy sputum is a classic sign of

acute pulmonary edema

green/yellow sputum is a classic sing of a

respiratory infection

a sudden increase in rate or respiratory effort suggest

deterioration

if you are assisting ventilations and it starts to become difficult, what do you suspect?

tension pneumothorax