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42 Cards in this Set

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signs mild to moderate hypoxia

tachypnea, dyspnea, tachycardia, pale-cool-clammy skin, increased BP, restlessness and agitation, disorientation/confusion, headache


signs severe hypoxia

tachypnea, dyspnea, tachycardia-dysrhythmias-eventually bradycardia, cyanosis, severe confusion, loss of coordination, sleepy appearance, head bobbing/droopy eyelids, slow reaction time, altered mental status, seizure

Sign of hypoxia in newborn

bradycardia


Snoring

upper airway partially obstructed

snoring tx

head tilt chin lift

crowing

muscles around larynx spasm narrowing the opening to the trachea

gurgling

presence of blood vomitus or liquid in upper airway

gurgling tx

sxn

stridor

harsh high pitched sound during inspiration significant upper airway obstruction, swelling in larynx, or obstruction by foreign object

technique used to open mouth in unresponsive/altered mental status pt

crossed finger technique and then inspect mouth-confirm clear

pt. breathing inadequately

provide positive pressure ventilation

open and maintain patent airway (3 things)

1- use one of open airway maneuvers (head tilt chin lift or jaw thrust)


2-sxn


3-mechanical airways (either NPA or OPA)

head tilt chin lift

used to open airway, don't use if suspected spinal injury


temporary maneuver


supplement w/OPA or NPA

infant head tilt chin lift

neutral position or "sniffing"



pad behind shoulders

jaw thrust

used to open airway w/suspected spinal injury

sxn catheters 2 types

hard tip-Yankauer/tonsil tip



soft catheter-french catheter

Yankauer used for

sxn mouth and oropharynx of unresponsive patient

French tip catheter used for

sxn nose and nasopharynx 80-120 mmHg

how to measure french tip catheter

if used for sxn nasopharynx - tip of nose to tip of ear



if snx oropharynx- measure tip of mouth to tip of ear

Amount of time appropriate to sxn adults and children

adults- no more than 15 sec


children - no more than 5 sec

pt producing frothy secretions and need to be ventilated

sxn 15 sec then ventilate & oxygentate x 2min and repeat as needed

OPA used for

unresponsive, no gag

measure OPA

corner of mouth to tragus of ear

OPA insertion

upside down and rotate 180 degree once at soft palate OR tongue depressor method- preferred for children and infants

NPA used for:

can't use OPA (biting, can't tolerate OPA), less likely to stimulate vomiting



not fully responsive and needs assistance maintaining an open airway but minimally intact gag reflex

contraindication of using OPA

suspected fx to base of skull or severe facial trauma

measure NPA

tip of nose to tip of ear

insertion of NPA

lubericate w/sterile water based lubericant, bevel against septum and then check airflow through airway

Assess adequate breathing (8)

1- look


2-listen


3-feel


4-auscultate bilaterally


5-rate


6-rhythm


7-quality


8-depth

Agonal respirations

gasping type breaths

need for pt to be ventilated

either inadequate rate OR tidal volume

ventilation rate with pulse adult/adolescent

10-12/min one every 5-6 seconds

ventilation rate child & Infant with pulse

12-20/min one every 3-5 seconds

ventilation rate newborn with pulse

40-60/min one every 1-1.5 seconds

hazards of O2

O2 toxicity


retina damage


respiratory depression w/COPD

changing O2 source

remove device from pt first

Nonrebreather

100% (actually 90%) O2


flow- prevent bag from collapsing typically 15 lpm

NC

24-44%


4% increase of O2 per lpm


flow 1-6 lpm

simple face mask

up to 60%


6-10 lpm

partial rebreather

35-60%


6-10 lpm

Venturi mask

percise O2 concentration

tracheostomy mask

typically less than 50%