Chapter 11: Airway Management, Emergency Care and Transportation of the Sick and Injured, 12th Edition

Aerosol-Generating Procedure

Treatments that increase the risk for transmission of infections that are spread through the air or by droplets; CPR is an example.

Agonal Gasps

Slow, gasping breaths, sometimes seen in dying patients.

Apneic Oxygenation

A technique in which oxygen administered via a high-flow nasal cannula is left in place during an intubation attempt, allowing for continuous oxygen delivery into the airways during all phases of the procedure.

Aspiration

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

Automatic Transport Ventilator (ATV)

A ventilation device attached to a control box that allows the variables of ventilation to be set. It frees the EMT to perform other tasks while the patient is being ventilated.

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.

Carina

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

Chemoreceptors

Chemical sensors in the brain and blood vessels that identify changing levels of oxygen and carbon dioxide. ("Body quality assurance things.")

Cheyne-Stokes Respirations

A cyclical pattern of abnormal breathing that increases and then decreases in rate and depth, followed by a period of apnea. (Often seen in PT's with stroke or head injury.)

Compliance

The ability of the alveoli to expand when air is drawn in during inhalation.

Denitrogenation

The process of replacing nitrogen in the lungs with oxygen to maintain a normal oxygen saturation level during intubation

Esophageal Intubation

Improper placement of an advanced airway device into the esophagus rather than into the trachea.

Exhalation

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

External Respiration

The exchange of gasses between the lungs and the blood cells in the pulmonary capillaries; also called pulmonary respiration. Exchange in the alveoli.

Gastric Distention

A condition in which air fills the stomach, often as a result of high volume and pressure during artificial ventilation.

Glottis

Opening between vocal cords.

Gum Elastic Bougie

A flexible device that is inserted between the glottis under direct laryngoscopy; the endotracheal tube is threaded over the device, facilitating its entry into the trachea.

Hemothorax

A collection of blood in the pleural cavity.

Hypercarbia

Increased carbon dioxide level in the bloodstream.

Hypoxia

Low oxygen saturation of the body, not enough oxygen in the blood.

Inhalation

The active, muscular part of breathing that draws air into the airways and lungs.

Delete

Delete

Intrapulmonary Shunting

Bypassing of oxygen-poor blood past nonfunctional alveoli to the left side of the heart.

Larynx

voice box; line between upper and lower airway.

Mediastinum

Area between the lungs containing the heart, aorta, venae cava, esophagus, and trachea. (Area behind the sternum.)

Oxygen Toxicity

A condition of excessive oxygen consumption resulting in cellular and tissue damage.

Parietal Pleura

Outer layer of pleura lying closer to the ribs and chest wall.

Partial Pressure

Term used to describe the amount of gas in air or dissolved in fluid, such as blood.

Passive Ventilation

The act of air moving in and out of the lungs during chest compressions.

Patent

Open, clear of obstruction. ( ______ airway)

Phrenic Nerves

The two nerves that innervate the diaphragm; necessary for adequate breathing to occur.

Pin-indexing System

A system established for portable cylinders to ensure that a regulator is not connected to a cylinder containing the wrong type of gas.

Pneumothorax

Air in the pleural cavity caused by a puncture of the lung or chest wall.

Stoma

An opening through the skin and into an organ or other structure created surgically, allowing for direct access to the body.

Surfactant

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

Tension Pneumothorax

An accumulation of air or gas in the pleural cavity that progressively increases pressure in the chest that interferes with cardiac function with potentially fatal results.

Tonsil Tips

Large, semirigid suction tips recommended for suctioning the pharynx; also called Yankauer tips.

Visceral Pleura

The membrane that covers the lungs.

Stridor

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

Ronchi

loud rumbling sounds heard on auscultation of bronchi obstructed by sputum

Rales

Crackles; wet crackling noise in lungs

Wheezing

High pitched sound heard in the lungs with asthmatics or lung disease.

Ischemia

An inadequate blood supply to an organ or part of the body, especially the heart muscles.

Oxygenation

The process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs.

Phrenic Nerve

Carries impulses to the diaphragm from the brain.

Internal Respiration

Exchange of gases between cells of the body and the blood. (Inside the body, not the alveoli.)

V/Q Mismatch

An imbalance in the amount of oxygen received in the alveoli and the amount of blood flowing through the alveolar capillaries

Hemopneumothorax

The accumulation of blood and air in the pleural space of the chest.

Anemia

Lack of a normal number of red blood cells.

Vasodilatory Shock

Abnormal increase in blood vessel diameter, decreasing blood pressure.

Ataxic Respirations

A pattern of irregular and unpredictable breathing commonly caused by brain injury.

Kussmaul Respirations

Very deep, rapid breathing. (usually associated with diabetic keto acidosis and renal failure)

Low Co2 Levels

- Hyperventilation.

- Decreased co2 return to the lungs.

- Reduced co2 production at the cellular level.

High co2 levels

- Ventilatory Inadequacy.

- Apnea.

End-tidal CO2

The amount of carbon dioxide present at the end of an exhaled breath.

PEEP

Positive end expiratory pressure.

CPAP

Increases pressure in the lungs, opens collapsed alveoli, pushes more oxygen across the alveolar membrane, and forces interstitial fluid back into the pulmonary circulation.

CPAP Settings

Pressures should be between 7.0 cm H2O and 10.0 cm H2O

100

Do not use a CPAP on a PT with less than ____ Systolic BP.

BEMAGIC

Use this mnemonic when performing endotracheal intubation.

B - perform BVM preoxygenation

E - evaluate for airway difficulties

M - manipulate the patient

A - attempt first-pass intubation (pass through the cords)

GI - use the supraGlottic or Intermediate airway if unable to intubate

C - confirm successful intubation