Airway, respiration, ventilation, and respiritory diseases EMT (JCCC EMS 132

the only floating bone

hyoid

how many atp do we get with no o2? with?

4, 32

what is the natural peep of humans (start at)

5

when would you increase peep

COPD as needed

when suctioning a stoma, how far down should you put it?

3-5 inches (anatomically)

when suctioning a stoma, what might you need to do first?

loosen secretions with 5 ml of water

peep stands for…

positive end expiratory pressure

normal etco2?

35-45 on monitor or on disposable one yellow=yes

when to use igel (LMA)/ indications

no gag reflex, BLS adjuncts are not working, you will be bagging them for a while (a code)

contraindications to igel

gag reflex, responsiveness, caustic ingestion, unrelieved airway obstruction, esophageal disease (varices).

what is normal etco2 for CPR

12-25=good CPR

cellular respiration is…

use of o2 and glucose to create energy

(TV-DS)xRR

alveolar respiration

tidal volume formula

6-8ml per kg

dead space/DS

average of 150 ml. It is air that is NOT on alveoli

vital capacity

air you can exhale after breathing out (TV+IRV+ERV)

inspiratory reserve volume and expiratory…

insp= air you can breathe in after normal breathe, exp= breathe out after normal breathe

residual volume

air left after breathing fully out that you CANT breath out. Keeps aleoli open

using a BVM on a flail chest is called

internal splinting

irregular with pauses

Ataxic/biots

causes for ataxic

strokes, trauma, medula oblongata damage

fast shallow then heavy and deep breaths then apnea then repeat

cheyne-stokes

causes for cheyne-stokes

trauma, tumors, heartfailure,

mean arterial pressure (MAP) formula is

DP + 1/3(SP-DP)

how long does a neb treatment normally last

5-7 mins

neb lpm?

6-8lpm

what is asthma

allergice reaction to inhaled, ingested, or injected substance.

what can make asthma worse

exercise, allergies, resp. infection

pathophys of asthma

inflammation of lungs and mucous production. Air trapping

follow up questions for asthma

hospitalization or intubation in past, stopped/ changed meds recently, use inhaler and how much, severity/ frequency of attacks, how acute was it, what meds do you take now and in past (what works best)

treatment for asthma

albuterol sulfate- 2.5 mg in 3 cc of saline AND ipratropium bromide- .5 mg in 2.5 cc of saline. O2, position of comfort

a PE is a…

moving clot

a clotting disease

coagulopathy

atrial fibulation

loves to make clots

A type of blood thinner (trade name)

warfarin

A type of blood thinner (generic)

coumidin

a fluid that keeps alveoli open

surfactant

digital clubbing is common in

COPD (chronic hypoxia)

pneumonia is an

opportunistic disease- takes advantage of weak

pneumonia is a result of

an infection of the lungs due to virus, bacteria, toxic exposure, or lung injury assoc. with drowning.

some special symptoms of pneumonia are

abdominal pain, N/V, fever, dry skin turgor (flap of skin when you grab knuckle), musculoskeletal (result of hypoxia), weight loss. Fontanelles sunken in infants.

follow up questions for dyspnea

productive or dry cough (if any)? Pain when breathing or coughing? History of cough, fever, orthopnea, chest pain, infection, hospitalization.

orthopnea

dyspnea while lying down

pleuritic chest pain is

a sharp pain in chest that occurs when pleura becomes inflamed.

why does a pneumothorax cause JVD

increased pressure on heart

the word(s) for increased BVM resistance

reduced compliance

what PMH can cause pulmonary edema?

MI, CHF, CAD a-fib, accents to high altitude recently

what does ntg do for pulmonary edema

lowers pre load

what is the gold standard for respiratory assessment

etco2

the most common cause for CHF

MI (past or right now)

JVD, pedal edema, weight gain

right sided heart failure

dyspnea, pink, frothy sputum, fatique, pulmonary edema

Left sided heart failure

put your fingers on skin, a depression is left bc of fluid

pitting edema

difficulty breathing at night while lying down

paroxysmal nocturnal dyspnea (PND)

Caused by Haemophilus influenzae. Fever, comes on fast, drooling, transport carefully DO NOT MAKE THEM CRY

epiglottitis

starts with cold like symptoms and mild fever and progresses into hacking cough then ____

pertussis/whooping cough

a common complication of pertussis is ____

pneumonia

cystic fibrosis

a disease that someone is born with that causes thick mucous to build up throughout the body. Blocks airways trapping germs, causing inflamation, and dyspnea/failure/arrest

how does cystic fibrosis affect digestive system

build up of mucous in pancreas inhibits release of digestive enzymes limiting absorption of nutrients. This causes growth abnormalities. Mucous can block bile ducts causing liver disease.

Cystic fibrosis commonly causes

respiratory infection- biggest cause of death from it is pulmonary disease.

what does RSV stand for and what is it?

respiratory syncytial virus- infection of respiratory tact (cold like symptoms)

history questions for viral resp infection

progression of illness (sudden, gradual), hydration status, exposed to illness recently, immunocompromised?

caused by viral infection, affects younger children more. Inflamation and swelling of larynx, trachea, and bronchi. Barking cough, stridor, starts with cold symptoms, worse at night.

croup

pulmonary embolism history questions.

recent surgery, DVT, broken bone, pregnant, bedrest, A-fib, cardiac valve problems

build up of excess acid

acidosis- less than 7

build up of excess base

alkalosis- more than 7

collapse of the alveolar air spaces

atelectasis

an infectious disease where a pseudomembrane forms, lining pharynx- can severely obstruct air passage into larynx

diphtheria

an allergic reaction to outside airborn allergens

hay fever

a collection of fluid between lung and chest wall that may compress the lung

pleural effusion

sharp stabbing pain in chest worsened by deep breath or other chest wall movement; often caused by inflammation to pleura.

pleuritic chest pain

term used to describe amount of gas in air or dissolved fluid such as blood

partial pressure

PE s/s

hemoptysis

dyspnea

tachycardia

tachypnea

cyanosis

acute chest pain

BVM issues recognition and solutions)

Failure to Size Up the • (MOANS)

Patient

M - mask seal (Beards, Blood,

Trauma)- wipe off face, good 2 person technique

O- Obesity/obstruction- weight pushes down and causes pressure- slower breath/2-3 seconds and watch for chest rise. Slower may help get passed obstruction.

A -Age>55- put towel under chin to help with grip (floppy skin)

N- No Teeth- go higher up on lips or even on gums with lower part of mask Putting it on alveoli of mandible.

S- Stiff Lungs - ARDs- slow breaths