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A method for (means of) correcting blockage of the airway by moving the jaw forward without tilting the head or neck; this method is indicated when trauma, or injury, is suspected to open the airway without causing further injury to the spinal cord in the neck

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Jaw-thrust maneuver

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A curved device inserted through the patient's mouth into the pharynx to help maintain an open airway

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Oropharyngeal air-way

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An airway that is open and clear and will remain open and clear, without interference to the passage of air into and out of the lungs

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Patent airway

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Vomiting or retching that may result when something is placed in the back of the pharynx; this is tied to the swallow reflex

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Gag reflex

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The passageway by which air enters or leaves the body; the structures of the airway are the nose, mouth, pharynx, larynx, trachea, bronchi, bronchioles and alveoli

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Airway

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A method of correcting blockage of the airway by the tongue by tilting the head back and lifting the chin; this method is indicated when no trauma, or injury, is suspected

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Head-tilt, chin-lift

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Use of a vacuum device to remove blood, vomitus and other secretions or foreign materials from the airway

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Suctioning

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A flexible breathing tube inserted through the patient's nose into the pharynx to help maintain an open airway

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Nasopharyngeal air-way

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During respiration, the movement of air into and out of the lungs requires that:

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air flow be unobstructed and move freely

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nasopharynx

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where the nasal passages empty into the pharynx

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laryngopharynx

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structures surrounding the entrance to the trachea

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vocal chords

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curtain like fibers that line either side of the tracheal opening; not only close shut for protection but also vibrate with the passage of air to create the voice

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cricoid ring

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1st of 16 cartilaginous rings that protect the trachea

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special considerations for children

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1) smaller nose and mouth 2) bigger tongue 3) narrower, flexible trachea 4) cricoid cartilage is less rigid and developed

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components of suctioning

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suction tip, suction catheters, collection container, container of sterile water, tubing

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3 rules of suctioning

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1) always use appropriate infection control practices 2) suction for no longer than 10 seconds 3) place the tip or catheter where you want to suction and suction on the way out

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hoarseness

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raspy voice as swelling builds up around vocal chords

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snoring

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sound of soft tissue of the upper airway creating impedance (or partial obstruction) to the flow of air.

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airway obstruction sounds

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gurgling, gasping, crowing, wheezing, snoring, and stridor

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bronchoconstriction

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that contraction of smooth muscle that lines the bronchial passages that results in a decreased internal diameter of the airway and increased resistance to air flow

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stridor

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a high pitched sound generated from partially obstructed air flow in the upper airway

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acute airway obstruction

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choking on a foreign body, vomit, blood

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obstruction over time

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edema from burns, trauma, or infection; decreasing mental status

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When a patient inhales, air enters the throat, which is divided into the:

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nasopharynx, oropharynx, and laryngopharynx

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The hypopharynx is also called the:

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laryngopharynx

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The large leaf-like structure that protects the opening to the trachea is called the:

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epiglottis

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When we say that a patient is experiencing lower airway obstruction, it is likely that:

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his or her bronchial passages or alveoli are congested

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Signs of a potential inadequate airway include what?

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absent air movement, unusual hoarse or raspy sound quality in the voice, abnormal noises such as wheezing, crowing, and stridor

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An inadequate airway in a child is defined as:

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retractions above the clavicles and between and below the ribs

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When you question an elderly woman with a respiratory complaint, she speaks in short, two- or three- world sentence. Is this significant?

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Yes, she is probably very short of breath

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Your patient was the driver of a car that stopped suddenly when she hit a pole. She was not wearing her seatbelt and has a bruise on her neck. When you question her, she speaks very softly and seems to have a raspy voice. Is this significant or just a sign of nervousness about the collision?

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Yes, low volume and raspy tone could be due to airway swelling from neck or laryngeal trauma

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One indication that a child is experiencing inadequate breathing is that she:

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has nasal flaring when breathing

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The very first step to aid a patient who is not breathing is to:

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administer oxygen

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What is the importance of mechanism of injury (MOI) to airway care?

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An injury can make airway care easier to manage then a medical emergency

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To open the airway of a patient with a suspected head, neck or spine injury, the EMT should use a what maneuver?

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jaw-thrust

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When performing the head-tilt, chin-lift maneuver, the EMT should:

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position himself at the top of the patient's head

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When performing the jaw-thrust maneuver, the EMT should do what?

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kneel at the top of the patient's head, stabilize the patient's head with forearms, use the index finer to push the angles of the patient's lower jaw forward

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The main purpose of the jaw-thrust maneuver is to:

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open the airway without moving the head or neck

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An oral or nasal airway should be:

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used to keep the tongue from blocking the airway

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If something is placed in the patient's throat, the gag reflex causes the patient to:

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vomit or retch

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An oropharyngeal airway of proper size extends from the:

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corner of the patient's mouth to the tip of the earlobe

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Alveoli

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Tiny sacs in grapelike bunches at the end of the airway • Surrounded by pulmonary capillaries • Oxygen and carbon dioxide diffuse through pulmonary capillary membranes

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What two questions must be answered when addressed in airway primary assessment?

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- Is airway open? - Will airway stay open?

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What are the typical adult sizes in Nasopharyngeal Airway?

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34, 32, 30, and 28 French

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What is the contraindication to using a nasopharyngeal airway?

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evidence of a basilar skull fracture: Battle's sign, raccoon eyes, cerebrospinal fluid/blood from ears

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Most airway problems in adults are caused by this:

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the tongue sliding into the airway.

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The preferred method of inserting an OPA in a child is by using this

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a tongue depressor

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If a gurgling sound is heard during artificial ventilation, you should do what?

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suction the patient immediately.

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this suctioning tip is a rigid device with a larger bore than most catheters, not used with responsive patient's, but it is possible.

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yankauer

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If large particles (teeth and solid particles) are found in the mouth, how should you remove them?

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using a finger sweep with a gloved finger

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Protection of the spine is important in a trauma patient but what takes priority over that?

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airway and breathing

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A patent airway requires control of the muscles that form the airway. This is referred to as what?

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intact muscle tone

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The trachea branches at the what and form two main stem bronchi

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carina

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In an adult patient, an oral airway should be inserted:

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upside down, with the tip toward the roof of the mouth, then flipped 180 degrees over the tongue

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A nasopharyngeal airway should be:

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measured from the patient's nostril to the earlobe

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When inserting a nasopharyngeal airway, lubricate the outside of the tube with:

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a water-based lubricant

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The purpose of suctioning may include removal of:

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blood, vomitus and other secretions

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When a patient begins to vomit, it is essential that you have a(n) what ready to go at the patient's side?

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suction unit

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You are treating a 29-year-old female who has major airway problems. She has thick secretions and blood in her upper airway that needs to be suctioned with a Yankauer. What is not true of a Yankauer suction tip?

answer

it is used most successfully with responsive patients

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airway

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the passageway by which air enters or leaves the body.

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retractions

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pulling in of the muscles when breathing

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Suctioning is best delivered with a patient in this position

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recovery position

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Airway Obstructions

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• Acute - Foreign bodies - Vomit - Blood • Occurring over time - Edema from burns, trauma, or infection - Decreasing mental status • Bronchoconstriction - Disorder of lower airway - Smooth muscle constricts internal diameter of airway

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Findings Indicating Airway Problems

answer

• Inability to speak • Unusual raspy quality to voice • Stridor • Snoring • Gurgling

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Signs of Inadequate Airway

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• Foreign bodies in airway • No air felt or heard (air exchange below normal) • Absent or minimal chest movements • Abdominal breathing

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Nasopharyngeal Airway

answer

• Soft, flexible tube inserted through nostril and into hypopharynx • Moves tongue and soft tissue forward to provide a channel for air • Can be used in patients with intact gag reflex or clenched jaw • Contraindicated if clear (cerebrospinal) fluid coming from nose or ears

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Suctioning Techniques

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• Suction no longer than 10 seconds at a time • Prolonged suctioning can cause hypoxia and bradycardia • If patient vomits for longer than 10 seconds, continue suction

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The first step of emergency care in the patient with inadequate breathing is:

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opening and maintaining the patient's airway

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During your assessment of a 54-year-old male patient, you find that he is not breathing; your next step should be to:

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begin providing artificial ventilations to the patient.

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Your 24-year-old female patient has fallen from the roof of her house and is unconscious. The best method of opening her airway is the:

answer

jaw-thrust maneuver

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Oropharyngeal airways can be used on unconscious patients, except those who:

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have a gag reflex.

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If you do not have the proper size oropharyngeal airway to fit your patient:

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do not use one.

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The nasopharyngeal airway is popular because it:

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often does not stimulate a gag reflex.

question

Which of the following is true when suctioning a patient's airway?

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Suction longer than 15 seconds if patient continues to vomit.

question

The most popular type of suction tip used in the pre-hospital setting is:

answer

rigid pharyngeal tip (Yankauer).

question

Despite all other patient care delivered, no patient will survive without a(n):

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open airway

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The EMT's chief responsibilities are finding and correcting immediately what problems?

answer

life-threatening

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The most common impediment to an open airway is the:

answer

tongue

question

List five steps in determining whether a patient's airway is adequate.

answer

• Look for adequate and equal expansion of both sides of the chest with inhalation. • Listen for air entering and leaving the nose, mouth, and chest. • Feel for air moving out of the nose or mouth. • Check for typical skin coloration—there should be no blue or gray colorations. • Note the rate, rhythm, quality, and depth of breathing typical for a person at rest.

question

List four general procedures to secure an airway.

answer

• Open the airway. • Insert an airway adjunct. • Suction the patient. • Place the patient in recovery position

Chapter 8- Airway Management – Flashcards

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