subcutaneous emphysema
the presence of air in the subcutaneous tissue
(crackling under the skin, swelling and bruising around neck, sore
... [Show More] throat/wheezing, can indicate pneumothorax)
traumatic asphyxia
intense compression of the thoracic cavity, causing venous back-flow from the right side of the heart into the veins of the neck and the brain (ex. motor vehicle accidents, industrial and farming accidents; swelling of face/neck; cyanosis, distended neck vein; subconjunctival bleeding in eyes; small spot-like hemorrhages)
pulmonary edema
excessive fluid in the lungs
(caused by: CHF, burns, drowning, blood stops pumping through the body; EXTREME SOB, dyspnea; feeling of suffocation, wheezing; cold clammy skin; coughing up pink frothy sputum; can indicate CHF, renal failure, fluid overload; low sats; may need CPAP or intubation)
COPD
disease characterized by a decreased ability of the lungs to perform the function of ventilation (similar umbrella terms: emphysema, chronic asthma, chronic bronchitis)
(cause: smoking; most likely elderly or someone that needs O2 on the daily; SOB, wheezing; chest tightness; chronic cough that might produce sputum; unintended weight loss; barrel chest; may tripod breath; sats run lower all the time; be careful giving too much oxygen -- may kill their respiratory drive and cause them to stop breathing -- but never withhold oxygen if respiratory distress is happening)
asthma
narrowing of airway, swells, and produce extra mucus
(troubled breathing after exertion; wheezing: especially inspiratory; most likely will have history of asthma; ask about activities before exercise, smokey room, allergens; ASSIST METERED DOSE INHALER)
chronic bronchitis
inflammation of the bronchial tubes
(cough with mucus/productive cough; SOB, wheezing; chest tightness; low fever; albuterol to help break up mucus)
emphysema
gradually damages the alveoli in lungs
(caused by smoking, SOB, most likely elderly or someone that needs O2 on the daily; lung sounds are distant and clear)
pneumonia
acute infection of the lung, alveolar spaces
(PRODUCTIVE COUGH, coarse rhonchi; chest pain, SOB different than normal; pale skin color and warm to touch; may need cpap or intubation)
cystic fibrosis
affects cells that produce mucus, sweat, and digestive juices
(cough sputum -- clear; LIGHT COATING OF SMALL CRYSTALLINE GRANULES; sweat test to diagnose; also cause problems with absorption in digestion, pt may have weight loss; respiratory tx.)
tension pneumothorax
collapse of the lung
(sudden chest pain; SOB, tachypnea; tachycardia, fatigue; faint heart sounds; unequal breath sounds; JVD; late sign: tracheal deviation; TREATMENT: high-flow oxygen via NRB and transport; paramedic needle decompression)
pulmonary embolism
occurs when a foreign object gets wedged into an artery in your lung
(pinpoint pain to left/right side of chest; dyspnea; sudden onset; cyanosis, low spO2; anything that can cause abnormal clotting -- like getting off blood thinners after surgery or having hip replaced -- also heart arrthymias like history of afib; TREATMENT: rapid transport)
acute myocardial infarction
tight chest, SOB; sweating, nausea, vomiting
atelectasis
alveoli collapse
epiglottitis
inflammation of the epiglottis
(sore throat and drooling; stridor; pink skin and hot to touch-infection; emergency; give O2)
severe acute respiratory syndrome
high fever, dyspnea, cpap
respiratory failure
for an adult, nasal flaring; hoarseness, coughing; sternal retractions; belly and chest move in opposite directions
cheyne stokes' respirations
progressively increased tidal volume, separated by periods of apnea at the end of expiration, typically seen in older patients
(associated with brainstem insult, sign death is close)
kussmaul's respirations
deep rapid breaths that result as a corrective measure against conditions like
diabetic ketoacidosis/metabolic acidosis; need bicarb to reverse acidosis
snoring
upper airway is partially obstructed, usually by tongue
(use head-tilt, shin-lift/jaw thrust)
stridor
harsh high pitched sound heard on inspiration and characteristic of an upper airway obstruction like croup
(croup, epiglottitis; airway closing)
wheezing
whistling sound due to narrowing of the airways by edema, bronchoconstriction, or foreign materials
(constriction/inflammation in the bronchus; asthma, COPD, CHF < pneumonia, bronchitis, anaphylaxis)
rhonchi
rattling sounds in the large airways associated with excessive mucus/other material (fluid movement heard on inspiration)
(COPD, pneumonia, bronchitis; crackles/rales: fine moist crackling sounds associated with fluid in the smaller airways; CHF, pneumonia, pulmonary edema)
agonal gasps
slow, shallow, irregular gasping breath
indication of npa
relief upper airway obstruction, alternative for opa, semiconscious, NEVER use with any head, face, mouth injuries
indication of opa
unconscious, any risk of airway obstruction like relaxed upper airway muscles, REMOVE WHEN GAG REFLEX IS PRESENT, meausre from the center of the mouth to the angle of the jaw, AVPU of U only
suction
when they're unconscious and/or have something in their mouth (blood/vomit) if the answer option is given, then roll/tilt backboard to the side no more than 15 seconds; ex. GURGLING RESPIRATIONS WITH BLEEDING INTO THROAT
bvm/assist with ventilation
when respirations are shallow, R=0, intercostal retractions, can't breath on their own
(should give an average 500mL while ventilating an adult patient (mimics normal air inspired during single inhalation); "severely" SOB; coughing pink frothy sputum, pedal edema, crackles = BVM; pt is months old, unresponsive, low pulse, low R and labored, in shock = BVM; if BVM fails, reposition airway and ventilate again)
nrb mask
when they are able to: breath on their own; dyspnea, tripod position; acute respiratory distress; tachypnea with clear equal breath sounds
% air given by...
pocket mask on room air gives 17% O2
room air itself gives 21%
mouth to mouth ventilations 16%
jaw thrust
with suspected cervical/spinal injury VS head-tilt chin-lift anytime you want to open airway W/O any cervical/spinal injury (reposition airway, jaw, etc. if there's inadequate chest rise during ventilation)
CHECK CAROTID PULSE BEFORE COMPRESSIONS!!!
(just a reminder?)
stoma
pediatric sized BVM over the stoma and ventilate
normal breathing rates
adults: 12-20 bpm
infants (0-1 yr): 30-60 bpm
toddler (1-3 yr): 24-40 bpm
(4-5 yrs): 22-34 bpm
(6-12 yrs): 18-30 bpm
LOOK AT DANGEROUS VITAL SIGNS!
if r = 0, OPEN AIRWAY
assessing breathing w/ unconscious patient; look for chest rise and fall
leading cause of infant and child death
RESPIRATORY ARREST
position
conscious, bleeding through nose/mouth, sit up and lean forward
choking
if coughing, encourage to cough; no cough, but conscious: 5 ABDOMINAL THRUST; if pregnant, use CHEST THRUSTS
abdominal thrust
partial airway obstruction, drooling, leaning forward, stridor [Show Less]