Chapter 6
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Patel 1 Tanvi Patel Ms.Alogna MRT / 45B 10/18/11 Chapter 5 Key Terms 1. Airway – passages from mouth and nose to air sacs in lungs; where air enters and leaves body 2. Airway Obstruction – partial or complete obstruction of respiratory passages; caused by blockage by food, small objects, or vomit. 3. Alveoli – air sacs of lungs, where oxygen and carbon dioxide are exchanged 4. Aspirator – a suction device 5. Bronchi – 2 main branches of windpipe that lead right and left lungs; branch into smaller airways in the lungs 6. Capillaries – smallest blood vessels that connect small arteries and small veins 7. Cardiopulmonary resuscitation (CPR) – artificial circulation of blood and movement of air into and out of the lungs in a pulseless, nonbreathing patient 8. Esophagus – tube through which food passes; starts at throat and ends at the stomach 9. Gag Reflex – involuntary effect to vomit caused by something placed or caught in throat 10. External Cardiac Compression – applying artificial circulation by applying rhythmic pressure and relaxation on lower half of the sternum 11. Head Tilt-Chin Lift – opening the airway by tilting the patient’s head back and lifting the chin forward, bringing the whole lower jawbone with it 12. Lungs – organs that supply the body with oxygen and eliminating CO2 from the blood 13. Heimlich Maneuver – series of manual thrusts to the abdomen to relieve of an obstruction 14. Jaw-Thrust Maneuver – opening airway by bringing the patient’s jaw forward without extending the neck 15. Mandible – lower jaw 16. Manual Suction Device – hand-powered devices used for clearing upper airway of mucus, blood, or vomitus 17. Mechanical Suction Device – battery powered pump or an oxygen-powered aspirator device used for clearing upper airway of mucus, blood, or vomitus 18. Ventilations – circulation or exchange of gasses in the lungs 19. Nasopharyngeal Airway – Nasal airway – artificial airway inserted into a patient who is unable to maintain a natural airway 20. Oropharyngeal Airway – Oral airway – artificial airway inserted in the mouth to keep the tongue from blocking the airway 21. Stoma – surgical opening in the neck that connects the trachea to the skin 22. Trachea – windpipe 23. Respiratory Arrest – sudden stoppage of breathing 24. OPA – oropharyngeal airway 25. NPA – nasopharyngeal airway 26. Respiratory Distress – labored or shortness of breath 27. Cyanosis – blue or purple skin, especially around the mouth 28. Patient Airway – oropharynx, nasopharynx, throat, trachea, lungs, diaphram, muscles 29. Bag Valve Mask Device - patient ventilation device; consist of: bag, one-way valves, face mask 30. Cricoid Pressure – posterior pressure applied to the cricoid cartilage to minimize gastric distention in non-breathing patients receiving positive pressure rescue breathing w/ a bag mask
Patel 2 31. Face-mask – clear, platic mask used for oxygen administration that covers moth and nose 32. Flow Meter – device on oxygen cylinders used to control and measure flow of oxygen 33. Minute Volume – volume of air inhaled or exhaled in a minute 34. Nasal Cannula – clear plastic tube used to deliver oxygen, that fits into patient’s nose 35. Pocket Mask – mechanical breathing device used for mouth to mask rescue breathing 36. Pulse Oximeter – machine that consists of a monitor and a sensor probe that measures the oxygen saturation in the capillary beds 37. Rescue Breathing – artificial mean of breathing for a patient 38. Sellick Maneuver – cricoid pressure - minimizes pastric distention and reduces risk of vomiting Assessment in Action 1. D 2. B 3. B 4. B 5. C 6. Jaw-thrust maneuver 7. Place patient in recovery position 8. Oropharynx, nasopharynx, epiglottis, throat, trachea, lungs, diaphram, chest muscles 9. No rising or falling of the chest, no sound of air moving in and out of patient’s nose and mouth 10. Keep the patient’s neck straight, examine and clean stoma, quickly clean and replace if there is a tube, then proceed with rexcue breathing as if the stoma is the mouth. In some cases, you may have to cover the mouth. Objectives The function of the respiratory system is to provide oxygen and to remove carbon dioxide from the red blood cells as they pass through the lungs. The respiratory system is made of the upper airway, lower airway, the lungs, and the diaphragm. The upper airway consists of the nasopharynx (nose), oropharynx (mouth), throat and epiglottis. The lower airway is made up of the trachea (windpipe), bronchioles, and main bronchus. There are also other muscles that help with breathing. Head Tilt-Chin Life Maneuver – First, place patient on their back and kneel beside the patient. Then place on hand on the patient’s forehead and apply pressure with your palm. Move the patient’s head as far back as possible. Place the tips of the fingers of your other hand under the bony part of the lower jaw near the chin. Finally, lift the chin to help tilt back the head. Jaw-Thrust Maneuver – Place the patient on their back and kneel at the top of the patient’s head. Place your fingers behind the angles of the patient’s lower jaw and move the jaw forward with firm pressure. Then tilt the head backward to a neutral or light sniffing position. Do not extend the cervical spine in a patient who has sustained an injury to the head or neck. Use your thumbs to pull down the patient’s lower haw, opening the enough to allow breathing through the mouth and nose. Once you have opened the airway, open the mouth to see if anything is blocking the airway. First, turn patient onto their side, then insert gloved fingers into the mouth. Curve your fingers into a C-shape and sweep from one side of the back of the mouth to the other side. Scoop out as much of the material as possible. Then to suction, lay patient on their back and insert the end of the suction tip into the patient’s mouth; now provide energy to suction. Make sure not to insert the tip farther than you can see. Do not suction more than 15 seconds at a time for an adult.
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Patel 3 6. For a presence of breathing, look for the rising and falling of the chest, the sound of air moving in and out of the nose and mouth, and feel the movements of air on the side of your face or ear. 7. Adequate breathing – rise and fall of chest, sound of air passing through nose and mouth, feel air on side of face or ear, normal breathing rate is 12-20 breaths/minute. Inadequate breathing – noisy respirations, wheezing, gurgling indicate partial blockage; rapid & gasping breaths & cyanosis indicate that the patient isn’t receiving enough oxygen; respiratory arrest indicates no breathing at all. Story “Hello students, I will be teaching this class today. You teacher had some things to take care of. Can any of you tell me how far you are?” Ms.Schin said. “Well, we are on the chapter of airway management. Ms.Till was going to show us how to do the head tilt-chin lift and jaw-thrust maneuvers.” Answered Uma. “Great, why don’t we review a little and then I can show you how to conduct the maneuvers. You, boy in the white shirt, be quiet. Why don’t you tell me your name and what an OPA is.” “I am Vinny, and what kind of teacher are you if you don’t know that OPA stands for oropharyngeal airway.” Vinny and the rest of the class began laughing. “Oh, so you are very smart huh? Ok then if you get my next question right, you can so whatever you want and if you don’t you shut up and sit there. Fair enough?” “Bring it on.” Ms.Schin performs the Heimlich maneuver on a dummy. Then she asks, “What is this maneuver called?” “Really, I thought you would challenge me a little, it’s the Heimlich maneuver, duh!” Jimmy arrogantly stated. “Wrong, don’t be so sure of yourself, the right answer is Sellick or Heimlich maneuver. Sorry now you have to sit silently.” “But…” “Nope, silent. Ok class, now that we are done with that, what human body part is most likely to be an airway obstruction?” “The tongue.” Said a shy voice. “Exactly, who said that?” “I did, I’m Winnie.” “Great, why don’t you come up here and you can help me demonstrate. I need one more person. Who can tell me the difference between the trachea and esophagus?” “The trachea is the windpipe and the esophagus takes food down to the stomach, my name is Xavier.” Xavier said very quickly. “Good, come on up Xavier. Ok now we are going to practice the two maneuvers.” When class ended, Vinny learned a lesson about being smart with subs, and Xavier finally got his chance to talk to Winnie. So it was a good day for Ms.Schin.
Patel 2 31. Face-mask – clear, platic mask used for oxygen administration that covers moth and nose 32. Flow Meter – device on oxygen cylinders used to control and measure flow of oxygen 33. Minute Volume – volume of air inhaled or exhaled in a minute 34. Nasal Cannula – clear plastic tube used to deliver oxygen, that fits into patient’s nose 35. Pocket Mask – mechanical breathing device used for mouth to mask rescue breathing 36. Pulse Oximeter – machine that consists of a monitor and a sensor probe that measures the oxygen saturation in the capillary beds 37. Rescue Breathing – artificial mean of breathing for a patient 38. Sellick Maneuver – cricoid pressure - minimizes pastric distention and reduces risk of vomiting Assessment in Action 1. D 2. B 3. B 4. B 5. C 6. Jaw-thrust maneuver 7. Place patient in recovery position 8. Oropharynx, nasopharynx, epiglottis, throat, trachea, lungs, diaphram, chest muscles 9. No rising or falling of the chest, no sound of air moving in and out of patient’s nose and mouth 10. Keep the patient’s neck straight, examine and clean stoma, quickly clean and replace if there is a tube, then proceed with rexcue breathing as if the stoma is the mouth. In some cases, you may have to cover the mouth. Objectives The function of the respiratory system is to provide oxygen and to remove carbon dioxide from the red blood cells as they pass through the lungs. The respiratory system is made of the upper airway, lower airway, the lungs, and the diaphragm. The upper airway consists of the nasopharynx (nose), oropharynx (mouth), throat and epiglottis. The lower airway is made up of the trachea (windpipe), bronchioles, and main bronchus. There are also other muscles that help with breathing. Head Tilt-Chin Life Maneuver – First, place patient on their back and kneel beside the patient. Then place on hand on the patient’s forehead and apply pressure with your palm. Move the patient’s head as far back as possible. Place the tips of the fingers of your other hand under the bony part of the lower jaw near the chin. Finally, lift the chin to help tilt back the head. Jaw-Thrust Maneuver – Place the patient on their back and kneel at the top of the patient’s head. Place your fingers behind the angles of the patient’s lower jaw and move the jaw forward with firm pressure. Then tilt the head backward to a neutral or light sniffing position. Do not extend the cervical spine in a patient who has sustained an injury to the head or neck. Use your thumbs to pull down the patient’s lower haw, opening the enough to allow breathing through the mouth and nose. Once you have opened the airway, open the mouth to see if anything is blocking the airway. First, turn patient onto their side, then insert gloved fingers into the mouth. Curve your fingers into a C-shape and sweep from one side of the back of the mouth to the other side. Scoop out as much of the material as possible. Then to suction, lay patient on their back and insert the end of the suction tip into the patient’s mouth; now provide energy to suction. Make sure not to insert the tip farther than you can see. Do not suction more than 15 seconds at a time for an adult.
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Patel 3 6. For a presence of breathing, look for the rising and falling of the chest, the sound of air moving in and out of the nose and mouth, and feel the movements of air on the side of your face or ear. 7. Adequate breathing – rise and fall of chest, sound of air passing through nose and mouth, feel air on side of face or ear, normal breathing rate is 12-20 breaths/minute. Inadequate breathing – noisy respirations, wheezing, gurgling indicate partial blockage; rapid & gasping breaths & cyanosis indicate that the patient isn’t receiving enough oxygen; respiratory arrest indicates no breathing at all. Story “Hello students, I will be teaching this class today. You teacher had some things to take care of. Can any of you tell me how far you are?” Ms.Schin said. “Well, we are on the chapter of airway management. Ms.Till was going to show us how to do the head tilt-chin lift and jaw-thrust maneuvers.” Answered Uma. “Great, why don’t we review a little and then I can show you how to conduct the maneuvers. You, boy in the white shirt, be quiet. Why don’t you tell me your name and what an OPA is.” “I am Vinny, and what kind of teacher are you if you don’t know that OPA stands for oropharyngeal airway.” Vinny and the rest of the class began laughing. “Oh, so you are very smart huh? Ok then if you get my next question right, you can so whatever you want and if you don’t you shut up and sit there. Fair enough?” “Bring it on.” Ms.Schin performs the Heimlich maneuver on a dummy. Then she asks, “What is this maneuver called?” “Really, I thought you would challenge me a little, it’s the Heimlich maneuver, duh!” Jimmy arrogantly stated. “Wrong, don’t be so sure of yourself, the right answer is Sellick or Heimlich maneuver. Sorry now you have to sit silently.” “But…” “Nope, silent. Ok class, now that we are done with that, what human body part is most likely to be an airway obstruction?” “The tongue.” Said a shy voice. “Exactly, who said that?” “I did, I’m Winnie.” “Great, why don’t you come up here and you can help me demonstrate. I need one more person. Who can tell me the difference between the trachea and esophagus?” “The trachea is the windpipe and the esophagus takes food down to the stomach, my name is Xavier.” Xavier said very quickly. “Good, come on up Xavier. Ok now we are going to practice the two maneuvers.” When class ended, Vinny learned a lesson about being smart with subs, and Xavier finally got his chance to talk to Winnie. So it was a good day for Ms.Schin.
