An active process in which the intercostal muscles and the diaphragm contract, expanding the size of the chest cavity and causing air to flow into the lungs
Inspiration/inhalation. (Limmer & O'keefe pg 444)
A muscular structure that separates the chest cavity from the abdominal cavity.
Diaphragm. (Limmer & O'keefe pg 444)
A passive process in which the intercostal muscles and the diaphragm relax, causing the chest cavity to decrease in size and forcing air form the lungs
Expiration/exhalation. (Limmer & O'keefe pg 445)
breathing may be determined by observing
Rate, rhythm, and quality. (Limmer & O'keefe pg 445)
Normal rate of breathing for adult is---child is---infant is---
12-20, 15-30, 25-50. (Limmer & O'keefe pg 445)
Use of accessory muscles, (may be pronounced in infants and children and involve nasal flaring, seesaw breathing, grunting, and retractions between the ribs, and above the clavicles and sternum) are signs and symptoms of..
Inadequate breathing. (Limmer & O'keefe pg 446)
In order of preference the means of providing assisted ventilation are...
1)pocket face mask with supplemental oxygen, 2)two-rescuer bag-valve mask with supplemental oxygen, 3)flow-restricted, oxygen-powered ventilation device. 4)one-rescuer bag-valve mask with supplemental oxygen. (Limmer & O'keefe pg 447)
In the rare circumstance when a patient with inadequate breathing is conscious enough to fight artificial ventilation,
transport immediately and consult medical direction. (Limmer & O'keefe pg 447)
A patient who is not breathing at all and has a pulse, you should
Provide ventilations at 12/minute for an adult and 20/minute for infant or child. (Limmer & O'keefe pg 448 )
You know artificial ventilations are adequate if you...
See rise and fall of chest. (Limmer & O'keefe pg 448)
When providing artificial ventilations in adults, the pulse that remains the same or increases may indicate
Inadequate artificial ventilations. (Limmer & O'keefe pg 448)
When providing artificial ventilations to a pediatric patient, the patient's pulse should....
Return to normal (increase). (Limmer & O'keefe pg 449)
Cyanosis, straining neck and facial muscles, tightness in chest, straining intercostals and abdominal muscles, numbness or tingling in hands and feet, flaring nostrils pursed lips, coughing, crowing, high-pitched barking, respiratory noises, wheezing, sno
Breathing difficulty. (Limmer & O'keefe pg 451)
Why should you refrain from putting anything in the pediatric patient's mouth
May set off spasms along the airway. (Limmer & O'keefe pg 449)
A normal pulse oximeter reading is
Between 96 to 100 percent. (Limmer & O'keefe pg 451)
High pitched sounds created by air moving through narrowed air passages in the lungs.
Wheezing. (Limmer & O'keefe pg 452)
Bubbling sound heard upon inspiration, caused by fluid in the alveoli
Crackles or rales. (Limmer & O'keefe pg 452)
Low pitched sounds resemble snoring caused by secretions in larger airways
Ronchi. (Limmer & O'keefe pg 452)
High-pitched sound of inspiration, upper-airway partial obstruction of the trachea or larynx
Stridor. (Limmer & O'keefe pg 452)
When patient who was wheezing is not moving enough air in and out of the lungs, you may hear
No wheezing. (Limmer & O'keefe pg 452)
You should use a nasal cannula on a patient
Who does not tolerate the non-rebreather mask. (Limmer & O'keefe pg 453)
Position the patient with breathing difficulty but adequate in position.......
Comfort. (Limmer & O'keefe pg 453)
To adequately provide ventilations to a patient, position patient ------
Supine. (Limmer & O'keefe pg 453)
A form of noninvasive positive pressure ventilation (NPPV) consisting of a mask and a means of blowing oxygen or air into the mask to prevent airway collapse or to help alleviate difficulty breathing
Continuous positive airway pressure (CPAP). (Limmer & O'keefe pg 453)
Patients with obstructive sleep apnea sometimes have these devices at home and use them at night
CPAP. (Limmer & O'keefe pg 453)
The CPAP is commonly used in emergency situations related to
Pulmonary edema and drowning, asthma, COPD. (Limmer & O'keefe pg 453)
Pathologic contraindications for the use of CPAP include; nausea and vomiting, penetrating chest trauma, (pneumothorax), shock, upper GI bleeding or recent gastric surgery; other contraindications include...
Lack of spontaneous respiratory rate, inability to sit-up, hypotension (less than 90 inability to maintain a good mask seal. (Limmer & O'keefe pg 453)
A side effect of the use of CPAP is
Hypotension. (Limmer & O'keefe pg 454)
a patient on CPAP mental status or respiratory condition deteriorates, you should
Remove the CPAP and begin ventilating the patient with BVM. (Limmer & O'keefe pg 454)
the brain determines when to breathe based on
Increased levels of carbon dioxide in the blood. (Limmer & O'keefe pg 456)
A patient with COPD brain determines to breath based on
Low oxygen in the blood. (Limmer & O'keefe pg 457)
Chronic disease that has episodic exacerbations or flares.
Asthma. (Limmer & O'keefe pg 457)
The characteristic breathing sound from asthma
Wheezing. (Limmer & O'keefe pg 457)
The abnormal accumulation of fluid in the alveoli of the lungs is known as...
Pulmonary edema. (Limmer & O'keefe pg 457)
When blood backs up into the systemic circulation from the right side of the heart, causing
Edema lower legs, sacral edema in bedridden pt. (Limmer & O'keefe pg 457)
When you auscultate the lungs of a patient with pulmonary edema , you will usually hear
Crackles or sometimes wheezes. Pt may cough up frothy sputum. (Limmer & O'keefe pg 458)
An infection of one or both lungs caused by bacteria, viruses, or fungi
Pneumonia. (Limmer & O'keefe pg 458)
Coughing (mucus greenish, yellow, or occasionally bloody), fever, chest pain, and severe chills. Shortness of breath, chest pain pleuritic, headache, pale, sweaty skin, fatigue, and confusion, crackles with auscultation
Signs and symptoms of pneumonia. (Limmer & O'keefe pg 458)
When a lung collapses without injury or any other obvious cause
Spontaneous pneumothorax. (Limmer & O'keefe pg 458)
A condition when a blood clot, air, or fat blocks an artery in the lungs
Pulmonary embolism. (Limmer & O'keefe pg 459)
The most common and dangerous type of blood clot is called
Deep vein thrombosis (DVT). (Limmer & O'keefe pg 459)
Patients with high potential for pulmonary embolism include
Recent immobilization or those with previous history of DVT. (Limmer & O'keefe pg 459)
Children with this disease often experience a sudden onset. A child sitting still leaning forward in the tripod position, drooling, and appearing to be in distress should alert the EMT to the possibility of this disease
Epiglottitis. (Limmer & O'keefe pg 460)
A genetic disease that typically appears in childhood. Causes thick, sticky mucus that accumulates in the lungs and digestive system.
Cystic fibrosis. (Limmer & O'keefe pg 460)
Most common affliction usually starts with a sore or scratchy throat with sneezing, a runny nose, and a feeling of fatigue.
Viral respiratory infections. (Limmer & O'keefe pg 460)
To help the patient use his inhaler you may have to
Get permission from medical direction. (Limmer & O'keefe pg 461)
Constriction, or blockage, of the bronchi that lead form the trachea to the lungs
Bronchoconstriction. (Limmer & O'keefe pg 461)
The use of this device makes the exact timing necessary to use an inhaler less critical.
Spacer. (Limmer & O'keefe pg 461)
Before using the inhaler you should ensure that you have the right patient, time, medication. Dose and route, check the expiration date and...
Inhaler should be at room temperature and shaken vigorously several times. (Limmer & O'keefe pg 461)
Have patient exhale deeply. Place the inhaler in patient's mouth and press the inhaler as pt ------- deeply
Inhales. (Limmer & O'keefe pg 461)
Daily use inhalers should-------in emergency situations
Not be used - use only fast-acting emergency inhalers. (Limmer & O'keefe pg 462)
Patient is unable to use the MDI, (not alert), inhaler is not prescribed for the patient, no permission from medical direction, the patient already taken the max dose...are..
Contraindications for use of MDI. (Limmer & O'keefe pg 464)
Beta-agonist inhalers actions
Dilates bronchioles, reducing airway resistance. (Limmer & O'keefe pg 464)
Side effects of MDI
Increased pulse rate, tremors, nervousness. (Limmer & O'keefe pg 464)
a method of delivery of albuterol that produces a continuous flow of aerosolized medication
Small Volume Nebulizer. (SVN). (Limmer & O'keefe pg 464)