Breathing patterns/lung sounds
ventilation/respiration
RSI
interventions/vitals
Other
100

Cheyne stokes

Gradualing increasing rete and followed by gradual decrease if reparations with periods of apnea; brainstem insult

100

Hypoxia

Tissues and cells do not receive enough oxygen

100

Contraindication

Cant get in BLS airway

100

ETCO2 detector types:

  • Colorimetric

  • Digital

  • digital /waveform

100

DOPE

  • Dislogment

  • Obstruction

  • Pneumothorax

  • Equipment failure

200

Kussmaul

Deep and rapid respirations (DKA)

200

signs of Inadequate breathing

  • Breathing rate of less than 12 or more than 20

  • Cyanosis

    • Position

    • Orthopnea

    • Chest rise and fall

    • Skin

    • Flared nostrils

    • Pursed lips

    • Retractions

    • Use of accessory muscles

    • Asymmetric chest wall movement

    • Quick breaths, long exhalation

    • Labored breathing

200

do you need to sedate for a GCS of 3

YES

200

Colorimetric capno

yellow good

purple bad

Reading after 6 to 8 positive pressure breaths

Replace with quantitative device as soon as possible

200

pt for drug admin 6 rights

  • Pt

  • Dose

  • Time

  • drug

  • Route

  • documentation

300

biot(ataxic)

Irregular pattern, rate, and depth of breathing with intermittent periods of apnea; results from increased ICP

300

Internal factors affecting oxygenation and respiration

  • Conditions that reduce surface area for gas exchange also decrease oxygen supply

  • Hypoglycemia

    • Oxygen and glucose levels decrease

  • Infection

    • Increases metabolic needs

    • Disrupts homeostasis

  • Hormonal imbalances

    • May result in ketoacidosis

300

Indications

For pt who cant control secretions

300

Waveform capnography phases

  • Phase 1(A-B): initial stage of exhalation

  • Phase 2(B-C): expiratory upslope

  • Phase 3(C-D): expiratory or alveolar plateau

  • Phase IV: inspiratory downstroke

300

ETCO2 detector types

  • Colorimetric

  • Digital

  • digital /waveform

400

Apneustic

Prolonged, gasping inhalation followed by extremely short, ineffective exhalation; associated with brainstem insult

400

Abnormal lung sounds

  • Weezing

  • Cracked

  • Diminished lung sounds

  • Expiratory wheezing

  • Pleural Rub

  • Ronchi

  • Stridor

400

Sequence-

Brain changer- Paralytic- TUBE- Sedation

400

Suctioning times

  • Adult: 15 sec

  • Child: 10 sec

  • Infant: 5 sec

  • Stoma 10 sec max

  • All get 2 mins of ventilation after sectioning before suction again except stoma.

400

LEMON

  • Look externally

    • The following can make intubation difficult

      • short , thick necks

      • Morbid obesity

      • Dental conditions

  • Evaluate (3-3-2)

    • 3- mouth width of more than 3 fingers in best

    • 3- mandible length of 3 fingers is best

    • 2- distance from hyoid bone to thyroid notch of 2 fingers wide is best

  • Mallampati

    • Note oropharyngeal structures visible in an upright, seated pt

      • Class one

        • Entire posterior pharynx is fully exposed

      • Class 4

        • Cant see anything

  • Obstruction

    • Note anything that might interfere with visualization or ET tube placement

      • Foreign body

      • Obesity

      • Hematoma

      • masses

  • Neck mobility

    • Sniffing position is ideal

500

Agonal

slow , shallow, irregular, or occasional gasping

500

Factors affecting ventilation

  • Intrinsic factors: infection, allergic reactions, unresponsiveness

    • The tongue is the most common obstruction in an unresponsive pt

    • Factors may not be directly part of the respiratory system

  • Extrinsic factors: trauma and foreign body airway obstruction

500

Medications-

Brain Changer- Etomidate, Ketamine

 Paralytic- Depolarizing (Succ) or Non-depolarizing (Ronium)

 Sedation- Versed, Ketamine

500

Contraindications CPAP

  • Unable to follow verbal commands

  • Respiratory arrest or agonal respirations

  • Unable to speak

  • Hypoventolation

  • Hypotention

  • Pneumothorax or chest trauma

  • Closed head injury

  • Facial trauma

  • Cordiogenic shock

  • Tracheostomy

  • GI bleed, nausea, or vomiting

  • Recent GI surgery

  • Unable to sit up

  • Unable to fit CPAP system

  • Cannot tolerate mask

500

Mallampati

  • Note oropharyngeal structures visible in an upright, seated pt

    • Class 1

      • Entire posterior pharynx is fully exposed

    • Class 4

      • Cant see anything

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