Aerobic metabolism
Metabolism that can proceed only in the presence of oxygen
agonal respirations
occasional, gasping breaths that occur after the heart has stopped
airway
the upper airway tract or the passage above the larynx, which includes the nose, mouth, and throat
alveolar ventilation
The volume of air that reaches the alveoli. It is determined by subtracting the amount of dead space air from the tidal volume
American Standard System
A safety system for large oxygen cylinders, designed to prevent the accidental attachment of a regulator to a cylinder containing the wrong type of gas
anaerobic metabolism
the metabolism that take place in the absence of oxygen; the principle product is lactic acid
apnea
absence of spontaneous breathing
aspiration
in the context of airway, the introduction of vomitus or other foreign material into the lungs
ataxic respirations
irregular, ineffective respirations that may or may not have an identifiable pattern
automatic transport ventilator (ATV)
A ventilation device attached to a control box that allows the variables of ventilation to be set. It frees the EMT to perform other tasks while the patient is being ventilated
bag-mask device
a device with a one-way valve and a face mask attached to a ventilation bag; when attached to a reservoir and connected to oxygen, delivers more than 90% supplemental oxygen
barrier device
a protective item, such as a pocket mask with a valve, that limits exposure to a patient's body fluids
bilateral
a body part or condition that appears on both sides of the midline
bronchioles
subdivision of the smaller bronchi in the lungs; made of smooth muscle and dilate or constrict in response to various stimuli
carina
point at which the trachea bifurcates (divides) into the left and right mainstem bronchi
chemoreceptors
monitor the levels of 02, CO2, and the pH of the cerebrospinal fluid and then provide feedback to the respiratory centers to modify the rate and depth of breathing based on the body's needs at any given time
compliance
the ability of the alveoli to expand when air is drawn in during inhalation
continuous positive airway pressure (CPAP)
a method of ventilation used primarily in the treatment of critically ill patients with respiratory distress; can prevent the need for endotracheal intubation
dead space
the portion of the tidal volume that does not reach the alveoli and thus does not participate in gas exchange
diffusion
a process in which molecules move from an area of higher concentration to an area of lower concentration
dyspnea
shortness of breath
exhalation
the passive part of the breathing process in which the diaphragm and the intercostal muscles relax, forcing air out of the lungs
external respiration
the exchange of gases between the lungs and the blood cells in the pulmonary capillaries; also called pulmonary respiration
gag reflex
a normal reflex mechanism that causes retching; activated by touching the soft palate or the back of the throat
gastric distention
a condition in which air fills the stomach, often as a result of high volume and pressure during artificial ventilation
glottis
the space in between the vocal cords that is the narrowest portion of the adult's airway; also called the glottic opening
good air exchange
a term used to distinguish the degree of distress in a patient with a mild airway obstruction. With good air exchange, the patient is still conscious and able to cough forcefully, although wheezing may be heard.
head tilt-chin life maneuver
a combination of two movements to open the airway by tilting the forehead back and lifting the chin; not used for trauma patients
hypercarbia
Increased carbon dioxide level in the bloodstream
hypoxia
a dangerous condition in which the body tissues and cells do not have enough oxygen
hypoxic drive
a condition in which chronically low levels of oxygen in the blood stimulate the respiratory drive; seen in patients with chronic lung diseases
inhalation
the active, muscular part of breathing that draws air into the airway and lungs
internal respiration
the exchange of gases between the blood cells and the tissues
intrapulmonary shunting
bypassing of oxygen-poor blood past nonfunctional alveoli to the left side of the heart
jaw-thrust maneuver
technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used for patients who may have a cervical spine injury
labored breathing
breathing that requires greater than normal effort; may be slower or faster than normal and usually requires the use of accessory muscles
larynx
a complex structure formed by many independent cartilaginous structures that all work together; where the upper airway ends and the lower airway begins; also called the voice box
manually triggered ventilation device
a fixed flow/rate ventilation device that delivers a breath every time its button is pushed; also referred to as a flow-restricted, oxygen-powered ventilation device
mediastinum
space within the chest that contains the heart, major blood vessels, vagus nerve, trachea, major bronchi, and esophagus; located between the two lungs
metabolism (cellular respiration)
the biochemical processes that result in production of energy from nutrients within cells
mild airway obstruction
occurs when a foreign body partially obstructs the patient's airway. the patient is able to move adequate amounts of air, but also experiences some degree of respiratory distress
minute ventilation
the volume of air moved through the lungs in 1 minute minus the dead space; calculated by multiplying tidal volume (minus dead space) and respiratory rate
nasal cannula
an oxygen-delivery device in which oxygen flows through two small, tubelike prongs that fir into the patient's nostrils; delivers 24% to 44% supplemental oxygen, depending on the flow rate
nasopharyngeal airway
airway adjunct inserted into the nostril of an unresponsive patient, or a patient with an altered LOC who is unable to maintain airway patency independently
nasopharynx
the nasal cavity; formed by the union of facial bones and protects the respiratory tract from contaminants
nonrebreathing mask
a combination mask and reservoir bag system that is the preferred way to give oxygen in the prehospital setting; delivers up to 90% inspired oxygen and prevents inhaling the exhaled gases (CO2)
oropharyngeal airway
airway adjunct inserted into the mouth of an unresponsive patient to keep the tongue from blocking the upper airway and to facilitate suctioning the airway, if necessary
oropharynx
forms the posterior portion of the oral cavity, which is bordered superiorly by the hard and soft palates, laterally by the cheeks, and inferiorly by the tongue
oxygenation
the process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs
parietal pleura
thin membrane that lines the chest cavity
partial pressure
the term used to describe the amount of gas in air or dissolved in fluid, such as blood
patent
open, clear of obstruction
phrenic nerve
nerve that innervates the diaphragm; necessary for adequate breathing to occur
pin-indexing system
a system established for portable cylinders to ensure that a regulator is not connected to a cylinder containing the wrong type of gas
pneumothorax
a partial or complete accumulation of air in the pleural space
poor air exchange
a term used to describe the degree of distress in a patient with a mild airway obstruction. Patient will have a weak cough, increased difficulty breathing, or possible cyanosis and may produce a high-pitched noise during inhalation (stridor)
positive end-expiratory pressure
Mechanical maintenance of pressure in the airway at the end of expiration to increase the volume of gas remaining in the lungs
pulse oximetry
an assessment tool that measures oxygen saturation of hemoglobin in the capillary beds
recovery position
a side-lying position used to maintain a clear airway in unconscious patients without injuries who are breathing adequately
residual volume
the air that remains in the lungs after maximal expiration
respiration
the process of exchanging oxygen and carbon dioxide
retractions
movements in which the skin pulls in around the ribs during inspiration
sellick maneuver
a technique that is used to prevent gastric distention in which pressure is applied to the cricoid cartilage; also referred to as cricoid pressure
severe airway obstruction
occurs when a foreign body completely obstructs the patient's airway. patients cannot breathe, talk, or cough
stoma
an opening through the skin and into an organ or other structure; a stoma in the neck connects the trachea directly to the skin
stridor
a high-pitched noise heard primarily on inspiration
suction catheter
a hollow, cylindrical device used to remove fluid from the patient's airway
surfactant
a liquid protein substance that coats the alveoli in the lungs, decreases alveolar surface tension, and keeps the alveoli expanded; a low level in a premature infant contributes to respiratory distress syndrome
tension pneumothorax
a life-threatening collection of air within the pleural space; the volume and pressure have both collapsed the involved lung and caused a shift of the mediastinal structures to the opposite side
tidal volume
the amount of air that is moved in or out of the lungs during one breath
tonsil tips
large, semirigid suction tips recommended for suctioning the pharynx
tracheostomy
surgical opening into the trachea
ventilation
exchange of air between the lungs and the environment, spontaneously by the patient or with assistance from another person, such as an EMT
visceral pleura
thin membrane that covers the lungs
vital capacity
the amount of air that can be forcibly expelled from the lungs after breathing in as deeply as possible
vocal cords
thin white bands of tough muscular tissue that are lateral borders of the glottis and serve as the primary center for speech production
wheezing
the production of whistling sounds during expiration such as occurs in asthma and bronchiolitis
ventilation
The exchange of air between the lungs and environment
ciliated mucous membrane
lines the nasopharynx that keeps contaminants such as dust and other small particles out of the respiratory tract
epiglottis
leaf-shaped cartilaginous structure that helps separate the digestive system from the respiratory system
exchange O2 and CO2
What is the function of the lower airway?
pulmonary ventilation
the process of moving air into and out of the lungs, is necessary for oxygenation and respiration to occur
oxygenation
process of loading oxygen molecules onto hemoglobin molecules in the bloodstream
Adults
12 to 20 breaths/min are normal for...
Children
15 to 30 breaths/min are normal for...
Infants
25 to 50 breaths/min are normal for...
cheyne-strokes respirations
This type of respiration is an irregular respiratory pattern in which the patient breathes with an increasing rate and depth of respirations that is followed by a period of apnea, or lack of spontaneous breathing, followed again by a pattern of increasing
hemoglobin saturation
A pulse oximeter measure the percentage of what?
adults
never suction more than 15 seconds in....
children
never suction more than 10 seconds in...
infants
never suction more than 5 seconds in...
Nasal Cannula
Which device is this?
Flow Rate: 1 to 6 L/min
Oxygen Delivered: 24% to 44%
Nonrebreathing mask
Which device is this?
FR: 10 to 15L/min
O2 Delivered: Up to 90%
Bag-mask
Which device is this?
FR: 15L/min
O2 Delivery: Nearly 100%
Mouth-to-mask
Which device is this?
FR: 15L/min
O2 Delivery: Nearly 55%
Adults
1 breath every 5 to 6 seconds in...
Children
1 breath every 3 to 5 seconds
Infants
1 breath every 3 to 5 seconds