Breathing in and out (inhalation and exhalation)
Ventilation. (Limmer & O'keefe pg 198)
The active process in which the muscles of the chest, including the intercostal muscles expand at the same time the diaphragm contracts in a downward motion. Creates a negative pressure
Inhalation. (Limmer & O'keefe pg 198)
The passive process the muscles relax and the size of the chest decreases, creates a positive pressure
Exhalation. (Limmer & O'keefe pg 198)
The amount of air moved in one breath
Tidal volume. (Limmer & O'keefe pg 198)
The amount of air moved in and out of the lungs per minute
Minute volume. (Limmer & O'keefe pg 198)
The area of the airway occupied by air not participating in oxygen exchange, about 150mL
Dead air space. (Limmer & O'keefe pg 198)
The amount of air that reaches the alveoli
Alveolar ventilation. (Limmer & O'keefe pg 199)
Process by which molecules move from an area of high concentration to an area of low concentration
Diffusion. (Limmer & O'keefe pg 199)
The exchange of oxygen and carbon dioxide between the alveoli and circulating blood in the pulmonary capillaries
Pulmonary respiration. (Limmer & O'keefe pg 199)
The exchange of oxygen and carbon dioxide between cells and circulating blood
Cellular respiration. (Limmer & O'keefe pg 199)
The respiratory and circulatory systems working together to maintain perfusion are often referred to as
Cardiopulmonary system also ventilation-perfusion (V/Q) match. (Limmer & O'keefe pg 199)
The diffusion of oxygen and carbon dioxide between the alveoli and the blood and between the blood and cells
Respiration. (Limmer & O'keefe pg 201)
An insufficiency of oxygen in the body's tissues
Hypoxia. (Limmer & O'keefe pg 201)
Increased work of breathing; a sensation of shortness of breath
Respiratory distress. (Limmer & O'keefe pg 201)
The reduction of breathing to the point where oxygen intake is not sufficient to support life
Respiratory failure. (Limmer & O'keefe pg 201)
Exchange of gases between the alveoli and the blood
External respiration. (Limmer & O'keefe pg 201)
Exchange of gases between the blood and the cells
Internal respiration. (Limmer & O'keefe pg 201)
In most people the urge to breathe is caused by the buildup of which gas
Carbon dioxide. (Limmer & O'keefe pg 201)
Special sensors in the cardiovascular system that detect increasing levels of carbon dioxide and low oxygen
Chemoreceptors. (Limmer & O'keefe pg 201)
The part of the autonomic nervous system that will increase heart rate and will constrict blood vessels in an attempt to move more blood
Sympathetic nervous system "fight or flight". (Limmer & O'keefe pg 201)
A patient who has a challenge to breathe but is compensating well is said to be in
Respiratory distress. (Limmer & O'keefe pg 201)
When respiratory compensation fails and the body needs are not met a patient is said to be in
Respiratory failure. (Limmer & O'keefe pg 201)
When breathing completely stops
Respiratory arrest. (Limmer & O'keefe pg 202)
EMT Intervention for a patient who is breathing adequately but has medical or traumatic condition
Oxygen by nonrebreather mask or nasal cannula. (Limmer & O'keefe pg 203)
EMT intervention for a patient who is moving some air in and out but not enough to live
PPV. (Limmer & O'keefe pg 203)
How to care for breathing on a patient who is visibly short of breath; speaking 3-4 word sentences; increasing anxiety
Nonrebreather mask (NRB). (Limmer & O'keefe pg 204)
How to care for breathing for a patient who is speaking 1-2 word sentences; very diaphoretic; severe anxiety
Assisted ventilations - Pocket face - mask - Bag-valve mask- FROPVD. (Limmer & O'keefe pg 204)
How to care for a patient in respiratory arrest
Artificial ventilations at 12/minute for adult or 20/minute for child or infant. (Limmer & O'keefe pg 204)
Normal rate for adult breathing
12-20 per minute. (Limmer & O'keefe pg 205)
Normal rate for child breathing
15-30 per minute. (Limmer & O'keefe pg 205)
Normal rate for infant breathing
25-50 per minute. (Limmer & O'keefe pg 205)
Movement associated with breathing is limited to the abdomen (abdominal breathing) is a sign of
Inadequate breathing. (Limmer & O'keefe pg 205)
Retractions above the clavicles and between and below the ribs in children are signs of
Labor breathing Inadequate breathing. (Limmer & O'keefe pg 205)
A blue or gray color resulting from lack of oxygen in the body
Cyanosis. (Limmer & O'keefe pg 205)
Cyanosis altered mental status with restlessness or confusion are signs of
Hypoxia. (Limmer & O'keefe pg 205)
Forcing air or oxygen into the lungs when a patient has stopped breathing or has inadequate breathing. Also called positive pressure ventilation
Artificial ventilation. (Limmer & O'keefe pg 208)
When we use positive pressure to ventilate we may cause the blood pressure to
Drop due to elimination of the negative pressure. (Limmer & O'keefe pg 208)
How do we reduce the risk from excessive positive pressure when ventilating
Using just enough volume for the chest to rise. (Limmer & O'keefe pg 208)
Filling the stomach with air during positive pressure ventilations is called
Gastric distention. (Limmer & O'keefe pg 208)
How can you minimize gastric distention from occurring
Using airway adjuncts and establishing proper head position. (Limmer & O'keefe pg 208)
Negative consequences from hyperventilation, or ventilating too quickly is blowing too much carbon dioxide off which causes....
Vasoconstriction, limiting blood flow to the brain. (Limmer & O'keefe pg 208)
To determine the signs of adequate artificial ventilation, you should
Watch for chest rise and fall and for adequate rate. (Limmer & O'keefe pg 208)
Sufficient rate of ventilations is
Adults 10-12, Children 20/min, infants minimum of 20/minute. (Limmer & O'keefe pg 208)
To protect the rescuer from the patient's body fluids what method of artificial ventilation is not recommended unless there is no other method available
Mouth-to-mouth. (Limmer & O'keefe pg 209)
When ventilating a patient who is breathing on his own but too rapidly, you should squeeze the bag when the patient inhales and
Adjust the rate so you are ventilating fewer times. (Limmer & O'keefe pg 209)
When ventilating a patient who is breathing on his own but too slow, you should squeeze the bag when the patient inhales and
Add ventilations in between to obtain a rate of about 12/min. (Limmer & O'keefe pg 209)
A new way of therapy for treating patients with inadequate breathing and respiratory distress
Noninvasive positive pressure ventilation (NPPV). (Limmer & O'keefe pg 209)
Two forms of NPPV are CPAP (continuous positive airway pressure) and BiPAP (biphasic continuous positive airway pressure) and can only be used on patients who
Are breathing on their own. (Limmer & O'keefe pg 210)
When high concentration oxygen is attached to the inlet of a pocket mask, it delivers an oxygen concentration of
Approximately 50 percent. (Limmer & O'keefe pg 210)
When ventilating through a pocket mask with no oxygen attached the concentration of oxygen delivered is
About 16 percent. (Limmer & O'keefe pg 210)
The one-way valve allows your ventilations to enter the patients mouth but prevent
The patient's exhaled air form coming back. (Limmer & O'keefe pg 210)
BVM systems without a reservoir deliver approximately
50 percent oxygen. (Limmer & O'keefe pg 213)
BVM with an oxygen reservoir deliver ____oxygen
Nearly 100 percent. (Limmer & O'keefe pg 213)
The bag holds anywhere from ---- to ---- mL of air
1,000 to 1,600. (Limmer & O'keefe pg 213)
BVMs with pop-off valves
Should be replaced. (Limmer & O'keefe pg 214)
When ventilating with a BVM the rescuer should squeeze the bag every _for adult and every __for child or infant
5 seconds for adult, 3 seconds child or infant. (Limmer & O'keefe pg 214)
Pressure applied to the neck to minimize air entry into the esophagus
Cricoid pressure also called Sellick maneuver. (Limmer & O'keefe pg 215)
The last choice of artificial ventilation procedure is using
One rescuer BVM. (Limmer & O'keefe pg 215)
If the chest does not rise and fall during BVM ventilation, you should, reposition the head, get a better mask seal, check for airway obstruction or in the BVM system, re-suction the patient, insert an airway adjunct - if none of these methods work you sh
Use an alternative method of artificial ventilation device. (Limmer & O'keefe pg 215)
The device of choice to ventilate a patient during one rescuer CPR is
The pocket mask with supplemental oxygen. (Limmer & O'keefe pg 215)
A permanent surgical opening in the neck through which the patient breathes
Stoma. (Limmer & O'keefe pg 215)
Patient with a stoma who is in severe respiratory distress and has thick secretions blocking the stoma should be
Suction the stoma and ventilate with a BVM to stoma. (Limmer & O'keefe pg 215)
How you position the head of a patient to ventilate through the stoma
Head and neck in a neutral position. (Limmer & O'keefe pg 216)
What type of mask should you use to ventilate the stoma
Pediatric size mask to provide a seal around the stoma. (Limmer & O'keefe pg 216)
If unable to ventilate through the stoma you should consider
Sealing the stoma and attempt to ventilate though the mouth and nose. (Limmer & O'keefe pg 216)
A manually triggered ventilation device, uses oxygen under pressure to deliver artificial ventilations through a mask
Flow-restricted, oxygen-powered ventilation device (FROPVD). (Limmer & O'keefe pg 216)
The FROPVD can give a peak flow rate of ----percent oxygen at up to ----liters per minute
100 percent oxygen at up to 40 liters per minute. (Limmer & O'keefe pg 216)
The FROPVD should be used only on
Adults unless you have a child unit. (Limmer & O'keefe pg 219)
A device that provides positive pressure ventilations. It includes settings designed to adjust ventilation rate and volume, is portable, and is easily carried on an ambulance
Automatic transport ventilator (ATV). (Limmer & O'keefe pg 218)
What device is beneficial for a patient who requires prolonged ventilation and there is only one rescuer available
The ATV. (Limmer & O'keefe pg 219)
The percentage of oxygen in the environment is
Approximately 21 %. (Limmer & O'keefe pg 219)
An oxygen cylinger filed with oxygen under pressure, equal to ----- to ----- pounds per square inch (psi) when full
2,000 to 2,200 psi. (Limmer & O'keefe pg 219)
D cylinder contains about ---liters of oxygen
350. (Limmer & O'keefe pg 219)
M cylinder contains about ___liter of oxygen
3,000. (Limmer & O'keefe pg 219)
The safe residual pressure in an oxygen tank is
200 psi. (Limmer & O'keefe pg 220)
Gauge pressure in psi minus the safe residual (200 psi) times the constant (each cylinder) and divided by the flow rate in liters per minute = ??? This formula determines...
The duration of flow in minutes. Example... (2,000 - 200) x 1.56/10=2,808/10 = 280.8 minute (Limmer & O'keefe pg 220)
When working with oxygen cylinders you should use only oxygen wrenches because other types of metal tools may
Produce a spark if they strike against metal. (Limmer & O'keefe pg 222)
The oxygen tank should be labeled
OXYGEN U.S.P. (Limmer & O'keefe pg 222)
Oxygen cylinders should be hydrostatically tested every
5 years. (Limmer & O'keefe pg 222)
A pressure regulator connected to the oxygen cylinder provides a safe working pressure of
30 to 70 psi. (Limmer & O'keefe pg 222)
The system that prevents an regulator form being connected to a different gas is called
Pin-index safety system. (Limmer & O'keefe pg 222)
A valve that indicates the flow of oxygen in liters per minute
A flow meter. (Limmer & O'keefe pg 222)
The low pressure flow meter, flow meter that must be maintained upright to deliver an accurate reading
Pressure-compensated flow meter. (Limmer & O'keefe pg 223)
Type of low pressure flowmeter, which has no gauge and allows for the adjustment of flow in liters per minute in stepped increments.
Constant flow selector valve. (Limmer & O'keefe pg 223)
A device connected to the flowmeter to add moisture especially good to use in long transport for patients with COPD or children
Humidifier. (Limmer & O'keefe pg 223)
When transporting a patient with conditions affected by high concentration oxygen the EMT should
Never withhold oxygen form a patient who needs it. (Limmer & O'keefe pg 225)
The nonrebreather mask at a flow rate of 12 - 15 liters per minute delivers an oxygen concentration of
80 to 90 percent. (Limmer & O'keefe pg 229)
The nasal cannula at 1 - 6 liters per minute delivers an oxygen concentration of
24 - 44 percent. (Limmer & O'keefe pg 229)
The partial rebreather mask used at home by some patients set at 9 to 10 liters per minute delivers a concentration of
40 - 60 percent. (Limmer & O'keefe pg 229)
The venturi mask used to deliver a specific concentration of oxygen depending on adapter tip and flow rate delivers up to 15 liters per minute and concentration of
24 - 60 percent. (Limmer & O'keefe pg 229)
Tracheostomy mask - used to deliver ventilations/oxygen through a stoma or Tracheostomy tube can be set up to deliver varying oxygen percentages when flow rate is at
8 - 10 liters per minute. (Limmer & O'keefe pg 229)
The best way to deliver high concentrations of oxygen to a breathing patient is
Nonrebreather mask. (Limmer & O'keefe pg 229)
Before you place the NRB on the patient you should
Prefill reservoir. (Limmer & O'keefe pg 229)
A patient who cannot tolerate a non-rebreather mask may be able to tolerate a
Nasal cannula. (Limmer & O'keefe pg 230)
The nasal cannula should only be used at a concentration of
4 to 6 liters per minute. (Limmer & O'keefe pg 230)
A face mask and reservoir bag device that delivers specific concentrations of oxygen by mixing oxygen with inhaled air
Venturi mask. (Limmer & O'keefe pg 231)
Devices most commonly used by patients with COPD
Venturi mask. (Limmer & O'keefe pg 232)
Designed to be placed over a stoma or Tracheostomy tube to provide supplemental oxygen.
Tracheostomy mask. (Limmer & O'keefe pg 232)
When suction units are not adequate for removing solid objects you should
Use manual techniques for clearing the airway. (Limmer & O'keefe pg 232)
What should you do with dentures that fit properly
Leave in place. (Limmer & O'keefe pg 232)
What should you do with partial dentures that become lose
Remove. (Limmer & O'keefe pg 232)
Devices that are inserted "blindly" include
King LT airway, Combitube, and laryngeal mask airway (LMA). (Limmer & O'keefe pg 233)
To pre-oxygenate a patient before intubation you should
Ventilate at a normal to slightly increased rate. (Limmer & O'keefe pg 233)
If the endotracheal tube was pushed in too far it will most likely enter the
Right mainstem bronchus. (Limmer & O'keefe pg 234)
While ventilating a patient with an endotracheal tube you notice a change of resistance, this may indicate
Air escaping through a hole in the lungs or the tube slipped into the esophagus. (Limmer & O'keefe pg 238)
How is the positioning of the head when inserting a blind-insertion device
Usually at a "neutral position". (Limmer & O'keefe pg 238)