Chapter 11 Airway Management Terms

Aerobic metabolism

Metabolism that can proceed only in the presence of oxygen

Aerosol-generating procedure

An airway manipulation that induces the production of aerosols that may present a risk for airborne transmission of pathogens, such as CPR

Agonal gasp

Abnormal breathing characterized by slow, gasping breaths, sometimes seen in patients in cardiac arrest

Airway

The upper tract or the passage above the larynx, which includes the nose, mouth, and throat

Alveolar minutes volume

The volume of air moved through the lungs in 1 minus the dead space; calculated by multiplying tidal volume (minus dead space) and respiratory rate

Alveolar ventilation

The volume of the air that reaches the alveoli. It is determined by subtracting the amount of dead space air from the tidal volume

American Standard Safety System

A safety system for large oxygen cylinders, designed to prevent the accidental attachment of a regulator to a cylinder containing the wrong type of gas

Anaerobic metabolism

The metabolism that takes place in the absence of oxygen; the main by-product is lactic acid

Apnea

Absence of spontaneous breathing

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 airway during all phases of the procedure

Aspiration

In the context of the airway, the introduction of vomitus or other foreign material into the lungs

Ataxic respirations

Irregular, ineffective respirations that may or may not have an identifiable pattern

Automatic transport ventilator (ATV)

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

Barrier device

A protective item, such as a pocket mask with a valve, that limits exposure to a patient's body fluids

Bilateral

A body part or condition that appears on both sides of the midline

Bronchioles

Subdivision of the smaller bronchi in the lungs; made of smooth muscle and dilate or constrict in response to various stimuli

Capnography

A noninvasive method to quickly and efficiently provide information on a patient's ventilatory status, circulation, and metabolism. It effectively measures the concentration of carbon dioxide in expired air over time

Capnometry

The use of the capnometer, a device that measures the amount of expired carbon dioxide

Carina

Point at which the trachea bifurcates (divides) into the left and right main stem bronchi

Chemoreceptors

Monitor the levels of oxygen, carbon dioxide, and pH of the cerebrospinal fluid and then provide feedback the respiratory centers to modify the rate and depth of breathing based in the body's needs at any given

Cheyne-Stokes respirations

A cyclical pattern of abnormal breathing that increases and than decreases in rate and depth, followed by a period of apnea

Compliance

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

Continuous positive airway pressure (CPAP)

A method of ventilation used primarily in the treatment of critically ill patients with respiratory distress; can prevent the need for endotracheal intubation

Dead space

Any portion of the airway that does contain air and cannot participate in gas exchange, such as the trachea and bronchi

Denitrogenation

he process of replacing nitrogen in the lungs with oxygen to maintain a normal oxygen saturation level during advanced airway management

Diffusion

Movement of a gas from an area of higher concentration to an area of lower concentration

Direct laryngoscopy

Visualization of the airway with a laryngoscope

Dyspnea

Shortness of breath

Endotracheal (ET) intubation

Insertion of an endotracheal tube directly through the larynx between the vocal cords and into the trachea to maintain and protect an airway

End-tidal CO2

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

Esophageal intubation

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

Exhalation

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

External respiration

The exchange of gases between the lungs and the blood cells in the pulmonary capillaries; also called pulmonary respiration

Gag reflex

A normal reflex mechanism that causes retching; activated by touching the soft palate or the back of the throat

Gastric distention

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

Glottis

The space in between the vocal cords that is the narrowest portion of the adult's airway; also called the glottic opening

Good air exchange

A term used to distinguish the degree of distress in a patient with a mild airway obstruction. With good air exchange, the patient is still conscious and able to cough forcefully, although wheezing may be heard

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

Head tilt-chin lift maneuver

A combination of two movements to open the airway by tilting the forehand back and lifting the chin; not used for trauma patients

Hemothorax

A collection of blood in the pleural cavity

Hypercarbia

Increased carbon dioxide level in the bloodstream

Hypoxia

Deficient oxygen concentration in the tissues

Hypoxic drive

A "backup system" to control respiration; senses drops in the oxygen level in the blood

Inhalation

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

Internal respiration

The exchange of gases between the blood cells and the tissues

Intrapulmonary shunting

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

Jaw-thrust maneuver

Technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used for patients who may have a cervical spine injury

Labored breathing

The use of muscles of the chest, back and abdomen to assist in expanding the chest; occurs when air movement is impaired

Larynx

A complex structure formed by may independent cartilaginous structures that all work together; where the upper airway ends and the lower airway begins; also called the voice box

Mediastinum

Space within the chest that contains the heart, major blood vessels, vagus nerve, trachea, major bronchi, and esophagus; located between the lungs

Metabolism

The biochemical processes that result in production of energy from nutrients within the cells, also called cellular respiration

Mild airway obstruction

Occurs when a foreign body partially obstructs the patient's airway. THe patient is able to move adequate amounts of air, but also experiences some degrees of respiratory distress

Minutes volume

The volume of air that moves into and out of the lungs per minutes; calculated by multiplying the tidal volume and respiratory rate; also called minute ventilation

Nasal cannula

An oxygen-delivery device in which oxygen flows through two small, tubelike prongs that fit into the patient's nostrils; delivers 24% to 44% supplemental oxygen, depending on the flow rate

Nasopharyngeal (nasal) airway

Airway adjunct inserted into the nostril of an unresponsive patient or a patient with an altered level of consciousness who is unable to maintain airway patency independently

Nasopharynx

The part of the pharynx that lies above the level of the roof of the mouth, or palate

Nonrebreathing mask

A combination mask and reservoir bad system that is the preferred way to give oxygen in the prehospital setting; delivers up to 90% inspired oxygen and prevents inhaling the exhaled gases (carbon dioxide)

Oropharyngeal (oral) airway

Airway adjunct inserted into the mouth of an unresponsive patient to keep the tongue from blocking the upper airway and facilitate suctioning the airway, if necessary

Oropharynx

A tubular structure that forms the posterior portion of the oral cavity, which is bordered superiorly by the hard and soft palates, laterally by the cheeks, and inferiorly by the tongue

Oxygenation

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

Oxygen toxicity

A condition of excessive oxygen consumption resulting in cellular and tissues damage

Parietal pleura

Thin membrane that lines the chest cavity

Partial pressure

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

Passive ventilation

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

Patent

Open, clear of obstruction

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 in not connect to a cylinder containing the wrong type of gas

Pneumothorax

An accumulation of air or gas in the pleural cavity

Poor air exchange

A term used to describe the degrees of distress in a patient with a mild airway obstruction. With poor air exchange, the patient often has a week, ineffective cough, increased difficulty breathing, or possible cyanosis and may produce a high-pitched noise during inhalation (stridor)

Preoxygenation

The process of providing oxygen, often in combination with ventilation, prior to intubation in order to raise the oxygen levels of body tissues; critical step in advanced airway management. This extends the time during which an advanced airway can placed in an apneic patient, because the more oxygen that is available in the alveoli, the longer the patient can maintain adequate gas exchange in the lungs during the procedure

Pulse oximetry

An assessment tool that measure oxygen saturation of hemoglobin in the capillary beds

Recovery position

A side-lying position used to maintain a clear airway in unconscious patients without injuries who are breathing adequately

Residual volume

The air that remains in the lungs after maximal expiration

Respiration

The process of exchanging oxygen and carbon dioxide

Retractions

Movement in which the skin pulls in around the ribs during inspiration

Severe airway obstruction

Occurs when a foreign body completely obstructs the patient's airway. The patient cannot breath, talk, or cough

Stoma

An opening through the skin and into an organ or other structure

Stridor

A harsh, high-pitched respiratory sound, generally heard during inspiration, that is caused by partial blockage or narrowing of the upper airway; may be audible without a stethoscope

Suction catheter

A hollow, cylindrical device used to remove fluid from the patient's airway

Surfactant

A liquid protein substance that coats the alveoli in the lungs, decreases alveolar surface tension, and keeps the alveoli expanded; a low level in a premature infant contributes to respiratory distress syndrome

Tension pneumothorax

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

Tidal volume

The amount of air (in mL) that is movies into or out of the lungs durings one breath

Tonsil tips

Large, semi-rigid suction tips recommended for suctioning the pharynx

Tracheostomy

A surgical procedure to create an opening (stoma) into the trachea; a stoma in the neck connects the trachea directly to the skin

Ventilation

The exchange of air between the lungs and the environment, occurs spontaneously by the patient or with assistance from another person, such as an EMT

Video laryngoscopy

Visualization of the vocal cords, and thereby placement of the endotracheal tube, that is facilitated by use of a video camera and monitor

Visceral pleura

Thin membrane that covers the lungs

Vital capacity

The amount of air that can be forcibly from the lungs after breathing in as deeply as possible

Vocal cords

Thin white bands of tough muscular tissues that are lateral borders of the glottis and serve as the primary center for speech production

Wheezing

A high-pitched, whistling breath sound that is most prominent on expiration, and which suggests an obstruction or narrowing of the lower airways; occurs in asthma and bronchiolitis