Limmer_2e_accessible_PowerPoint_07edited.pptx

EM R Complete: A Worktext Second Edition Chapter 7 Airway Copyright © 2014 Pearson Education, Inc. All Rights Reserved Topics Anatomy and Physiology Revisited Opening the Airway Oropharyngeal Airways EM R Patient Assessment: Breathing EM R Patient Care: Breathing Ventilating Patients Foreign Body Ai...

EM R Complete: A Worktext Second Edition Chapter 7 Airway Copyright © 2014 Pearson Education, Inc. All Rights Reserved Topics Anatomy and Physiology Revisited Opening the Airway Oropharyngeal Airways EM R Patient Assessment: Breathing EM R Patient Care: Breathing Ventilating Patients Foreign Body Airway Obstruction Copyright © 2014 Pearson Education, Inc. All Rights Reserved Introduction The most important skill To survive the patient must be – Breathing deeply enough – Breathing at an adequate rate Copyright © 2014 Pearson Education, Inc. All Rights Reserved Anatomy and Physiology Revisited Copyright © 2014 Pearson Education, Inc. All Rights Reserved Figure 7.1 Anatomy of the upper airway Copyright © 2014 Pearson Education, Inc. All Rights Reserved Anatomy and Physiology (1 of 5) Inhalation (inspiration) – Intercostal muscles and diaphragm contract. – This causes a negative pressure inside of the lungs, which draws in air. Copyright © 2014 Pearson Education, Inc. All Rights Reserved Anatomy and Physiology (2 of 5) Exhalation (expiration) – Intercostal muscles and diaphragm relax. – This causes pressure in the lungs to rise and air to be forced out. Copyright © 2014 Pearson Education, Inc. All Rights Reserved Anatomy and Physiology (3 of 5) Pulmonary ventilation Oxygenation Respiration Copyright © 2014 Pearson Education, Inc. All Rights Reserved Anatomy and Physiology (4 of 5) Copyright © 2014 Pearson Education, Inc. All Rights Reserved Anatomy and Physiology (5 of 5) Copyright © 2014 Pearson Education, Inc. All Rights Reserved Breathing Problems Chest muscles and diaphragm are not contracting Airway is obstructed Breathing is too shallow Breathing is too fast or too slow Copyright © 2014 Pearson Education, Inc. All Rights Reserved Respiratory Rates Adult – 12–20 breaths per minute Child – 15–30 breaths per minute Infant – 30–60 breaths per minute Copyright © 2014 Pearson Education, Inc. All Rights Reserved Assessing the Airway and Breathing (1 of 3) Airway patency Presence of cyanosis Positioning of patient Breathing adequacy Copyright © 2014 Pearson Education, Inc. All Rights Reserved Assessing the Airway and Breathing (2 of 3) Signs of respiratory distress ‒ Noisy breathing ‒ Accessory muscle use ‒ Anxiety or restlessness ‒ Poor skin condition ‒ Presence of trauma Copyright © 2014 Pearson Education, Inc. All Rights Reserved Assessing the Airway and Breathing (3 of 3) Use your senses to evaluate the airway – Observe the scene – Listen – Look for signs of hypoxia Copyright © 2014 Pearson Education, Inc. All Rights Reserved Opening the Airway Copyright © 2014 Pearson Education, Inc. All Rights Reserved Head-Tilt, Chin-Lift Maneuver Copyright © 2014 Pearson Education, Inc. All Rights Reserved Jaw-Thrust Maneuver Copyright © 2014 Pearson Education, Inc. All Rights Reserved Suction (1 of 2) Suction units Suction catheters Copyright © 2014 Pearson Education, Inc. All Rights Reserved Suction (2 of 2) Suctioning technique Copyright © 2014 Pearson Education, Inc. All Rights Reserved Oropharyngeal Airways (1 of 2) Copyright © 2014 Pearson Education, Inc. All Rights Reserved Oropharyngeal Airways (2 of 2) Copyright © 2014 Pearson Education, Inc. All Rights Reserved E M R Patient Assessment: Breathing Copyright © 2014 Pearson Education, Inc. All Rights Reserved EM R Patient Assessment: Breathing (1 of 3) Are the following patients breathing adequately? – Patient is sitting in a chair, complaining of chest pain. He is alert and able to speak in complete sentences without difficulty. – You respond to a call where you find the patient on the ground, unresponsive. Breathing is slow and shallow. You note gurgling sounds, and the patient is very pale. Copyright © 2014 Pearson Education, Inc. All Rights Reserved EM R Patient Assessment: Breathing (2 of 3) Are the following patients breathing adequately? – Patient fell down stairs. He is holding his badly broken leg and screaming in pain. Breathing is rapid and deep. – Patient is thrown from a car during a rollover. His color is poor and he is not moving or talking. There is no chest rise and no air appears to be moving in or out of his mouth or nose. Copyright © 2014 Pearson Education, Inc. All Rights Reserved EM R Patient Assessment: Breathing (3 of 3) Factors to consider – Rate and depth – Abnormal sounds – Mental status – Increased or decreased pulse and respiratory rates – Movement of the chest – Effort or work of breathing Copyright © 2014 Pearson Education, Inc. All Rights Reserved EM R Emergency Care: Breathing Copyright © 2014 Pearson Education, Inc. All Rights Reserved Figure 7.8a Explain to the patient the need for oxygen Copyright © 2014 Pearson Education, Inc. All Rights Reserved Oxygen Pulse oximeter Copyright © 2014 Pearson Education, Inc. All Rights Reserved Oxygen Delivery to Patients (1 of 6) Cylinders – Safety – Size Regulators Copyright © 2014 Pearson Education, Inc. All Rights Reserved Oxygen Delivery to Patients (2 of 6) Oxygen cylinders Copyright © 2014 Pearson Education, Inc. All Rights Reserved Oxygen Delivery to Patients (3 of 6) Oxygen cylinders Copyright © 2014 Pearson Education, Inc. All Rights Reserved Oxygen Delivery to Patients (4 of 6) Supply tubing Masks Copyright © 2014 Pearson Education, Inc. All Rights Reserved Oxygen Delivery to Patients (5 of 6) Masks – Nonrebreather mask – Venturi mask Copyright © 2014 Pearson Education, Inc. All Rights Reserved Oxygen Delivery to Patients (6 of 6) Oxygen delivery with a mask Copyright © 2014 Pearson Education, Inc. All Rights Reserved Nasal Cannula (1 of 2) Lower oxygen concentration May be used when patient is too anxious to tolerate a mask Copyright © 2014 Pearson Education, Inc. All Rights Reserved Nasal Cannula (2 of 2) Oxygen delivery with a nasal cannula Copyright © 2014 Pearson Education, Inc. All Rights Reserved Ventilating Patients Copyright © 2014 Pearson Education, Inc. All Rights Reserved Ventilation with the Pocket Face Mask (2 of 2) Ventilation port One-way valve Port to provide oxygen Copyright © 2014 Pearson Education, Inc. All Rights Reserved Ventilation with a Bag-Valve Mask (BV M) (1 of 2) Copyright © 2014 Pearson Education, Inc. All Rights Reserved Ventilation with a Bag-Valve Mask (BV M) (2 of 2) BV M procedure Copyright © 2014 Pearson Education, Inc. All Rights Reserved Ventilation with a Bag-Valve-Mask (BV M) Breathing patients – Breathing inadequately – Procedure  Explain the procedure to the patient  Apply the mask  Squeeze the bag as the patient inhales  Encourage 10-12 breaths per minute  Difficult procedure Copyright © 2014 Pearson Education, Inc. All Rights Reserved Foreign Body Airway Obstruction Copyright © 2014 Pearson Education, Inc. All Rights Reserved Figure 7.12a Universal sign of choking Copyright © 2014 Pearson Education, Inc. All Rights Reserved Foreign Body Airway Obstruction (1 of 3) Two categories of patients – Mild obstruction – Severe obstruction Copyright © 2014 Pearson Education, Inc. All Rights Reserved Foreign Body Airway Obstruction (2 of 3) Pregnant or obese patients Copyright © 2014 Pearson Education, Inc. All Rights Reserved Foreign Body Airway Obstruction (3 of 3) Unresponsive patients Copyright © 2014 Pearson Education, Inc. All Rights Reserved Copyright This work is protected by United States copyright laws and is provided solely for the use of instructors in teaching their courses and assessing student learning. Dissemination or sale of any part of this work (including on the World Wide Web) will destroy the integrity of the work and is not permitted. The work and materials from it should never be made available to students except by instructors using the accompanying text in their classes. All recipients of this work are expected to abide by these restrictions and to honor the intended pedagogical purposes and the needs of other instructors who rely on these materials. Copyright © 2014 Pearson Education, Inc. All Rights Reserved