emt 6/26

OPA indications and contraindications

to create or maintain a patent airway in an unconscious patient with no gag reflex any patient who has a gag reflex

two types of tips of suction

tonsil tip/rigid tip/Yankauers (measure like OPA) french/whistle tip catheter

assisted ventilation

usually for hyperventilations patients sync ventilations with inhalations after 5-10 breaths, deliver an appropriate tidal volume maintain adequate volume

types of regulaters/flow meters and requirements

yoke-type prssure reducing guage Bourdon guage pressure compensated flowmeter 2-25 L/min (usually we do 15)

side effects of albuterol

Hypertension, tachycardia, anxiety, restlessness

air we breathe in vs out concentration

In: 78% N 21% O2 1% other Out: 78% N 16% O2 5% CO2 1% other

NPA indications and contraindications

Indications: to create or maintain a patent airway in a semi conscious or unconscious patient with a gag reflex Contraindications: less than 12 mos of age (infants)

what do we change for OPQRST for resp. distress

Q: is it harder to breateh in or out R: observe rate, rhythm quality S: mild, moderate, or severe resp distress (ask and listen)

methods of ventilation in order of preference

mouth to mask when alone 2-person bmv device flow-restricted, oxygen powered device 1-person BMV technique

structure of upper airway

nasopharynx, oropharynx, laryngopharynx larynx epiglottis

we can assist with

nitroglycerin, metered dose inhaler, epi pen (LA and DOT)

indications for NBM

patients with adequate tidal volume and rate but actual or impending resp. failure patients with expected or confirmed exposure to toxins

COPD-E

pink puffers polycythemia - excess RBC (flush color) Barrel chest- air trapping + accessory muscle use pursed lip breathing - loss of lung elasticity and to avoid atelectasis (alveoily collapse) prone to spontaneous pneumo

inhalor administration instructions

room temp or warmer shake stop O2 exhale deeply hold as long as possible (or 10 sec) exhale through pursed lips check lung sounds 3 minutes after

Asthma vs. Anaphylaxis

skin signs! asthma- normal, just wheezing anaphylaxis - tachycardia, tachypnea, decreased BP, flush, hot, urticaria, wheezing, pruritis (itch), edema

what 5 things cause pulmonary edema

superheated gases, chemicals, pneumonia, left-sided heart problems, near-drowning

Measurement of NPA

measure from ant tragus/earlobe to side/tip/septum of nose eyeball nostril diameter or diameter of pinkey

Venturi mask

medium flow, blend ambient air, 24-40% O2, works on venturi principle

what is recovery position

modified left lateral w/leg up

COPD bronchitis

1. Blue Bloaters (cyanotic) 2. Large quantity of sputum 3. Productive cough 4. Destruction of cilia 5. Tend to be overweight Wheezing and rhonchi give high flow O2 and assist with inhaler if available

non rebreather mask textbook flow rate? delivers? putting on?

10-15 L/min up to 90% O2 inflate reservoir bag first

how long to suction

15 sec for adult 10 sec for pediatric 5 sec for infants

Nasal Canulla O2? flow rate? how to put on?

24-44% 1-6 L/min prongs point down (toward lungs)

normal breathing rates

Adult: 12-20 breaths per minute Child: 15-30 breaths per minute Infant: 25-50 breaths per minute

Albuterol: indications and contraindications

Asthma/difficulty breathing with wheezing patient unable to help coordinate inhalation, max dose prescribed per episode has been given

causes of blood clots mnemonic

BADPLRS Birth control, atrial fibrillation, deepn vein thrombrosis prolonged immobiloization, recent surgery long bone fracture sickle cell anemia

Wheezing: Rales: Rhonchi: Stridor: sound + causes

Wheezing: bronchial constrict-- anaphylaxis, asthma, COPD bronchitis Rales: pulmonary edema, fluid in base Rhonchi: infection of lower airway (course bubbling) Stridor: upper airway obstruction. Either mechanical or croup or epiglottitis

other drugs

activated charcoal narcan ASA epinephrine glucometer

pulmonary embolism signs and symptoms

acute dyspnea acute pleuritic pain (pinpoint) hemoptysis cyanosis tachypnea hypoxia

3 types of irregular breathing

ataxis (biot's) Cheyne-stokes (regularly irregular) Kussmaul breathing (deep, rapid breath) (DKA) (diabetics)

3 types of COPD

chronic bronchitis (air passages obstructed) , emphysema (alveoli damage), asthma (bronchial contriction)

cpap stands for

continuous positive airway pressure for pulmonary edema or severe brocho spasm

pleural effusion

diminished lung sound at base, clear up top collection of fluid on pleura causes dyspnea no moi normal skin signs

DICCE

drug/doctor/dose, integrity, clarity, color, expiration date

3 types of infections of airway and S+S

epiglottitis: 6mos-3years, bacterial, makes stridor sound, fever, chills, nausea, vomiting, drooling croup: 6mos-3y, viral. stridor, fever, chills, nausea, vomiting, barking seal (lower) pneumonia: bacteria, virus, fungi, parasites

3 ways to measure OPA

from angle of jaw to middle of mouth from anterior portion of tragus to corner of mouth from anterior portion of earlobe to corner of mouth

we can administer

glucose, oxygen

how to set up BMV

green end hooks to butt end red portion hooks up to christmas tree set 15 L/min hook mask to front end point part over nose, round end under lips CE grip with head hand

how do you try to open an airway

head tilt chin lift modified jaw thrust neutral sniffing

how to put in

hold it upside down and put in mouth rotate airway 180 degrees until flange rests on patients lips (or 90degree method) peds/infants goes straight in

how to put in

lubricate airway (lubricant or patient's saliva) open bigger nostril always have bevel side toward septum, insert twist if you get resistance have patient swallow during