Airway, Ventilation, Oxygenation

Hypoxemia

Hypoxemia is a low oxygen content in arterial blood

Hypoxia

Hypoxia means inadequate oxygen is being delivered to the cells

Mild to Moderate Hypoxia

• Restlessness, anxiety, and agitation

  • Tachypnea 

  • Dyspnea 

  • Pale, cool, clammy skin 

  • Tachycardia 

  • Elevation in blood pressure

Severe Hypoxia

• Tachypnea

• Dyspnea

• Cyanosis

• Tachycardia/dysrhythmias/bradycardia

• Severe confusion/AMS

• Loss of coordination

• Sleepy appearance

• Head bobbing 

• Slow reaction time

Cellular Hypoxia

Inadequate Oxygen delivered to cells. Disturbance in ventilation or respiration

Impaired Pulmonary Ventilation (Etiology)

• Interruption of nervous control

• Damage to thorax

• Increased airway resistance

• Loss of airway patency

Hypoperfusion

• Poor perfusion also leads to cellular hypoxia. 

• It may be caused by:

  • Obstructed forward movement of blood

  • Hypovolemia

Snoring

• caused by the tongue obstructing the airway

Crowing

• caused by muscle spasms around the larynx

Gurgling

• caused by liquid in the airway

Stridor

• swelling of the larynx

Effects of Positive Pressure Ventilation

• PPV does not rely on negative pressure

• Air is forced into the alveoli.

• PPV ↑ airway wall pressure

• PPV can lead to gastric distention by overcoming esophageal opening pressure, 

• Negative pressure from spontaneous breathing assists blood return to the heart

  • PPV decreases cardiac output.

Bag-Valve-Mask

• Can deliver close to 100% oxygen

CPAP (Continuous positive airway pressure)

• Patient criteria

  • Awake and can obey commands

  • Can maintain his airway

  • Breathing on his own, respiratory distress 

  • Has signs and symptoms of moderate to severe respiratory distress, or early respiratory failure

• (Auto-peep, may need c-pap)

What type of patients do you not give oxygen to? (can worsen conditions)

• Stroke and heart attack patients

NBR Mask needs to at least have how what kind of flow rate?

• 10-15 lpm

A Nasal Cannula needs to at least have how what kind of flow rate?

• 2lpm - 6lpm