Assessment and Treatment of the Respiratory System For the Paramedic Student Heather Davis, MS, NREMT-P

Primary Assessment u Ensure Patency –open airway –airway adjunct u Assess for Sounds of Compromise –suction u Assess adequacy of Breathing u Ventilate as Needed u Administer Oxygen as Needed

Secondary Assessment u History u Physical Exam –inspection –auscultation –palpation

Non-invasive Monitoring u Pulse oximetry u Capnography

Basic Airway Management u Universal precautions u Ensure patency u Protect C-spine u Perform manual maneuvers u Use basic airway adjuncts u Use advanced maneuvers for maximum effectiveness

Manual Airway Maneuvers u Highly effective and require no special equipment –Head-tilt/chin-lift –Jaw-thrust –Modified jaw-thrust –Sellick’s maneuver

Basic Mechanical Airways u Lift tongue off of oropharynx; used after manual maneuvers –Oropharyngeal –Nasopharyngeal

Advanced Airway Management u EOA u EGTA u PTL u Combitube u Endotracheal Intubation u Digital Intubation u Transillumination Intubation u Nasotracheal Intubation

More Advanced Airways u Special Circumstances –Trauma patient –Children –RSI –Foreign body removal

Surgical Airways u Needle Cricothyrotomy u Transtracheal Jet Ventilation

Suctioning u Equipment –suction units –suction catheters u Hazards –hypoxia, dysrythmias, vagal stimulation, gag u Techniques

Oxygenation u Benefits of oxygen administration –increases percent O2 in inspired air –increases O2 concentration in alveoli –increases arterial O2 levels –increases O2 delivered to tissues

Oxygen Delivery Devices u Nasal Cannula u Simple Face Mask u Nonrebreather Mask u Venturi Mask

Ventilation u Goals of ventilation –Overcome elastic resistance of lungs –maintain a good seal –maintain patent airway –deliver adequate ventilatory volumes –avoid gastric distention and regurgitation

Ventilation u Procedures and Devices –mouth-to-mouth –pocket mask –BVM –demand valve –autovent

Any Questions?