Emr 7/8/9

Airway Management,

infant

regular pulse rate,

resperations

blood pressure

90-180 heart beat/min

25-60 breaths/min

50-95 mm Hg

children

regular pulse rate,

resperations

blood pressure

70-150 heart beats/min

15-30 breaths/min

80-110

Adults

regular pulse rate,

resperations

blood pressure

60-100 heart beats/,min

12-20 breaths/min

90-140

what two passages are at the back of the throat?

esophagus

trachea

Has pulse but not breathing

what do you do?

check airway

2 manuever’s for blocked airway

head tilit- chin lift

jaw-thrust

Jaw-thrust maneuver

if you suspect a neck injury.

.

if you find anything in patients mouth what do you do?

remove it

finger sweeps

WEAR GLOVES

Suctioning

Suction machines can be helpful in removing

secretions.

• manual

• mechanical

manual suction

Insert the end of the

suction tip into the

patient’s mouth and

squeeze or pump the

hand-powered pump.

mechanical suction

Clear the patient’s mouth with your gloved

finger.

Turn on the suction device and use the rigid

tip to remove the rest of the material.

when using mechanical suction do NOT suctino for more than…

15 seconds at a time

unconcious patient w/ airway issue vs breathing patient

1. unconcicous=jaw thrust/head tilt chin lift manuever

2. concious= recovery position

unconcious patients DO NOT have a ___ reflex

gag

how to select proper size of ORAL airway adjunct

measuring

from the earlobe to the corner of the mouth.

how to select proper size of NASAL airway adjunct

earlobe to the tip of the patient’s nose.

Coat the airway with a water-soluble lubricant.

The airway is fully inserted when the flange or

trumpet rests against the patient’s nostril.

signs of inadequate breathing

• Noisy respirations, wheezing, or gurgling

• Rapid or gasping respirations

• Pale or blue skin

• respiratory arrest,

signs of respiratory arrest

Lack of chest movements

Lack of breath sounds

Lack of air against the side of your face

causes of respiratory arrest

Heart attacks

Mechanical blockage or obstruction caused by the tongue

Vomitus, particularly in a patient weakened by a condition such as a stroke

Foreign objects

Illness or disease

Drug overdose

Poisoning

Severe loss of blood

Electrocution by electrical current or lightning

mouth-to mouth Rescure Breathing

1. Pinch the nose, take a deep breath, and blow slowly into the mouth for 1 second.

2. Remove your mouth and let the lungs deflate.

After the first two breaths, breathe once into the mouth every 5 to 6 seconds.

(higher risk of contracting disease than other methods of rescue breathing)

methods of rescure breathing

1. mouth to mouth

2. mouth to mask

3. mouth to barrier

Bag Valve Mask (BVM)

Use of a bag-valve

mask is best

accomplished as a

two-person operation.

remember using it in class

hard to use correctly and get full rbeaths in to person with just one person

aiway adjunts

keep airway open

rescue breathing for children

use les force when using maneuevers

1 rescue breath every 3-5 seconds

if mild aiway obstruction, encourage patient to do what?

to cough

severe airway obstruction

The patient is unable to breathe in or out and

speech is impossible.

symptoms may include

• loss of ocncious in 3-4 minutes

treatment:

• abdominal thursts(heimlich)

airway obstruction in child

head tilt-chin lift manuever just baove neutral position

If the child becomes unresponsive, perform

CPR for five cycles before activating the EMS

system.

airway obstruction infants

Use a combination of back slaps and chest

thrusts.

unresponsive:

Ensure that the EMS system has been

activated.

Begin CPR.

Continue CPR until more advanced EMS

personnel arrive.

Oxygen Equipment (name 3)

• oxygen cylinders

• Pressure

  regulator/flowmeter

• Nasal cannulas and face masks

oxygen cylinders

• compressed to 2,000 psi and stored in portable cylinders.

• D or E size.

• each cylinder

  should last for at least

  20 minutes.

Pressure

regulator/flowmeter

• attache to the outlet of the oxygen cylinder

• Can be adjusted to deliver oxygen at a rate of 2-15 L/min

• gasket ensures a tight seal.

Nasal cannulas and face masks

• Ensures the oxygen is delivered to the patient

  and is not lost in the air

• cannulas are used to deliver medium

  concentrations of oxygen.

  A face mask is placed over the patient’s nose and mouth to deliver oxygen.

  • Nonrebreathing masks most common

REMEMBER, oxygen cylinders can be dangerous if not put in safe place

falmable

can cause fire/explosion

nasal cannula

flow of oxygen L/min

concentratino of oxygen

• low-flow

  oxygen at 1 to 6 L/min

  and in concentration of

  24% to 44% oxygen

Non breathing mask

flow of oxygen L/min

concentratino of oxygen

• high flow of oxygen

  at 8 to 15 L/min

• concentrations of

  oxygen as high as

  90%

Pulse oximetry

assess the amount

of oxygen saturated in

the red blood cells.

healthy patient - oxygen saturation should be between what percents?

95% - 100%

pulse oximeter limitations.

can give inaccurate reading if patient cold, lost blood, has sdirty fingers, etc.

only use finger sweep if you can___ the object

SEE,

NEVER blindly finger sweep, dont want to push to obejct further back

if a patient has a stoma, it means they…

have a surgically created opening on the surface of the body that allows for the discharge of waste or air.

(always protect soma area)

Rescue Breathing for Patients

With Stomas

Examine the stoma and clean away any

mucus in it.

If there is a breathing tube, remove it.

using rescure breahting method

Gastric Distention

cause- when air is forced into the stomach

instead of the lungs

Increases the chance that the patient will

vomit

dental appliances

when to remove and when not to remove when doing aiway mangement

if firmly attached- do NOT remove

if NOT firmly attached - REMOVE

airway managment in vehicle (patient in sitting or semireclining position)

Put one hand over the patient’s chin and the

other hand on the back of the patient’s head.

do a sort of chin lift

(dont have ot enter vehicle, can do though window)

ABCD

airway

breathing

circulation

decision

Venticular fibilieration (v-fib)

electrical activity in the ventricles becomes chaotic and disorganized, causing the heart to quiver instead of pumping effectively.

Approximately ___ of patients in cardiac

arrest are in a state of ventricular fibrillation.

70%

4 major artery locations

neck(cartoid)

arm(brachrial)

wrist(radial)

groin(femoral

blood (4 parts)

white blood cells

red blood cells

plasma

platelets

Platlets function

start blood-clotting process

red blood cells

carry oxygen from the lungs to the body and bring carbon dioxide back to the lungs.

(oxygen caryying)

White blood cells

devour bacteria and other

disease-causing organisms.

(infection fighting)

bloods is ___% plasma and _% cells

55

45

cardiac arrest

when the heart stops

contracting and no blood is pumped through

the blood vessels.

during cardiac arrest Brain damage begins within ___minutes

4-6 minutes

infant pusle

check brachial pulse

cpr on infant

2 fingers in middle

small child cpr, hand placement

heel of hand in center between two nipples

One-rescuer adult CPR, chest compression to breathing ratio

30:2

two rescuer cpr, CPR should not be interrupted for more than__sec

10

one rescue infant CPR

30:2

100-120 compressions per minute (sternum)

Two-rescuer infant CPR

15:2

100-120 compressions per min (same for all ages)

Name 3 Complications of CPR

1. Broken Ribs

2. Gastric Distention

3. regurgatation(common during CPR), make need to reopen airway, clear vomitus

(V-fib).

• a rapid, disorganized, and ineffective

vibration of the heart.

• An electric shock applied to the heart will defibrillate it and reorganize the vibrations into effective heartbeats.