Chapter 10: Respiration and Artificial Ventilation

Limmer, Daniel. Emergency Care (14th Edition)

Alveolar Ventilation

the amount of air that reaches the alveoli.

Artificial Ventilation

the use of positive pressure to force air or oxygen into the lungs when a patient has stopped breathing or has inadequate breathing. Also called positive pressure ventilation.

Automatic Transport Ventilator (ATV)

a device that provides positive pressure ventilations. It includes settings designed to adjust ventilation rate and volume. is portable, and is easily carried on an ambulance.

Bag-Valve Mask (BVM)

a handheld device with a face mask and self-refilling bag that can be squeezed to provide artificial ventilations to a patient. It can deliver air from the atmosphere or oxygen from a supplemental oxygen supply system.

Cellular Respiration

the exchange of oxygen and carbon dioxide between cells and circulating blood.

Cyanosis

a blue or gray color resulting from lack of oxygen in the body.

Diffusion

a process by which molecules move from an area of high concentration to an area of low concentration.

Flowmeter

a valve that indicates the flow of oxygen in liters per minute.

Humidifier

a device connected to the flowmeter to add moisture to the dry oxygen coming from an oxygen cylinder.

Hypoxia

an insufficiency of oxygen in the body’s tissues.

Nasal Cannula

a device that delivers low concentrations of oxygen through two prongs that rest in the patient’s nostrils.

Nonrebreather (NRB) Mask

a face mask-and-reservoir nag device that delivers high concentrations of oxygen. The patient’s exhaled air escapes through a valve and it not rebreathed.

Oxygen Cylinder

a cylinder filled with oxygen under pressure.

Partial Rebreather Mask

a face mask and reservoir oxygen bag with no one-way valve to the reservoir bag, so some exhaled air mixes with the oxygen; used in some patients to help preserve carbon dioxide levels in the blood to stimulate breathing.

Pocket Face Mask

a device, usually with a one-way valve, to aid in artificial ventilation. A rescuer breathes through the valve when the mask is placed over the patient’s face. It also acts a barrier to prevent contact with a patient’s breath or body fluids. It can be used with supplemental oxygen when fitted with an oxygen inlet.

Positive Pressure Ventilation

the use of positive pressure to force air or oxygen into the lungs when a patient has stopped breathing or has inadequate breathing. Also called artificial ventilation.

Pressure Regulator

a device connected to an oxygen cylinder to reduce cylinder pressure so it is safe for delivery of oxygen to a patient.

Pulmonary Respiration

the exchange of oxygen and carbon dioxide between the alveoli and circulating blood in the pulmonary respiration.

Respiration

the diffusion of oxygen and carbon dioxide between the alveoli and the blood (pulmonary respiration) and between the blood and the cells (cellular respiration). Also known as simply breathing.

Respiratory Arrest

when breathing completely stops.

Respiratory Distress

increased work of breathing; a sensation of shortness of breath.

Respiratory Failure

the inadequacy of breathing to the point where oxygen intake or the ventilation removal of carbon dioxide is not sufficient to support life.

Stoma

a permanent surgical opening in the neck through which the patient breathes.

Tracheostomy Mask

a device designed to be placed over a stoma or tracheostomy tube to provide supplemental oxygen.

Ventilation

breathing in and out (inhalation and exhalation), or artificial provision of breaths.

Venturi Mask

a face mask-and-reservoir bag device that delivers specific concentrations of oxygen by mixing oxygen with inhaled air.

When should you give supplemental oxygen to patients with chest pain?

Shortness of breath, hypoxia, or low oxygen saturation.

What should you use to administer low-concentration oxygen to patients with chest pain?

A nasal cannula

What should you use to administer high-concentration oxygen to patients with chest pain?

A nonrebreather mask

What is the best way to deliver high concentrations of oxygen to breathing patients with chest pain?

A nonrebreather mask

What is the flow rate for a nonrebreather mask?

12-15 liters per minute.

What is the flow rate of a nasal cannula?

1-6 liters per minute.

When should a nonrebreather mask be used?

Patients with signs of hypoxia with shortness of breath, chest pain, and altered mental status.

What concentration of oxygen does a nasal cannula provide?

22-44%

What concentration of oxygen does a non rebreather mask provide?

80-90%

What is the flow rate of a partial rebreather mask?

9-10 liters per minute.

What concentration of oxygen does a partial rebreather mask provide?

40-60%

What is the flow rate for a venturi mask?

Varied, up to 15 liters per minute

What concentration of oxygen does a venturi mask provide?

24-60%

What is the flow rate of a tracheostomy mask?

8-10 liters per minute.

What concentration of oxygen does a tracheostomy mask provide?

8-10 liters per minute via supply tubing.

What are special considerations in airway management?

Facial injuries, obstructions, and dental appliances.

What are anatomic considerations for children and infants in airway management?

Tongue takes up mor space, trachea is softer and more flexible, chest wall is softer and diaphragm breathing is more important, and oxygen burn rate is twice the adult rate.

What type of process is inhalation? (active or passive)

Active

What happens during inhalation?

Chest muscles expand and the diaphragm contracts, the size of the chest increases, and negative pressure pulls air into lungs.