Patient Assessment - Respiratory for EMT-P (1) Airway, Respiration and Ventilation

Define:

Adventitious Breath Sounds

Abnormal airway sounds.

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What position do patients sit in when experiencing respiratory distress?

Tripod position
Semi-Fowler position

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What is the normal respiratory rate in infants?

25-50 breaths/min.

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What is the normal respiratory rate in children?

15-30 breaths/min.

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What is the normal respiratory rate in adults?

12-20 breaths/min.

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Define:

Orthopnea

Shortness of breath when lying flat.

Typical in obese patients and those with heart failure.

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List visual assessment questions for the Respiratory Distress patient.

Patient position?
How adequate is the rise and fall of the chest?
Gasping for air?
Skin color?
Flaring of nostrils?
Pursed Lips?
Retractions?
Accessory muscle use?
Is the chest wall moving symmetrically?
Rate or rhythm of breathing?

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Define:

Paradoxical Motion

Chest segment moves:

IN during inhalation.
OUT during exhalation.

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What causes Paradoxical Motion?

flail chest

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Define:

Pulsus Paradoxus

Systolic BP drops more than 10 mmHg during inhalation.

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What causes Pulsus Paradoxus?

Pericardial tamponade
Severe COPD
Tension pneumothorax

Increased intrathoracic pressure

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What commonly exacerbates Asthma?

cold weather
stress

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What is a good assessment tool for indication of an intact gag reflex?

eyelash reflex

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How do you assess breath sounds?

Anteriorly
Posteriorly

Key areas:

Apex
Base
Bilaterally

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Define:

Cheyne-Stokes respiration

Increasing rate and depth of breathing, followed by a decrease, and a period of apnea.

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What indicates Cheyne-Stokes respiration?

brainstem insult

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Define:

Kussmaul respiration

Rapid and deep breathing.

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What indicates Kussmaul respiration ?

Diabetic Ketoacidosis

(DKA)

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Define:

Biot respiration

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Irregular rate and depth of breathing, with periods of apnea.

What indicates Biot respiration?

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Increased intracranial pressure.

Define:

Agonal respiration

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Shallow, slow and irregular breathing.

What indicates Agonal respiration?

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Near death, caused by cerebral hypoxia.

If there is concern for upper airway obstruction, what breath sounds should you also obtain?

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Tracheal breath sounds

Define:

I/E ratio

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The ratio between inhalation and exhalation in terms of time.

What is the normal **I/E Ratio**?

1 : 2 ## Footnote 1: inhalation 2: exhalation

What **I:E ratio** will be seen in patients who have **difficulty exhaling?**

1:4 or 1:5

# Fill in the blank: **Always** auscultate directly on the patient's \_\_\_\_\.

skin

# Define: wheezing

**High-pitched** breath sound.

What causes **wheezing**?

* COPD * Anaphylaxis * Asthma

# Define: Rhonchi

**Coarse crackles** throughout the larger lower airways. ## Footnote Rhonchi are worse than crackles.

What causes **rhonchi**?

* Pulmonary edema * Bronchitis

# Define: crackles

**Popping sounds** from the lower airway and often clear from coughing.

# Define: stridor

**High pitched and loud** heard during inhalation.

What causes **stridor**?

* Foreign body obstruction * Upper airway obstruction ## Footnote Inflammation of structures,

What does a **pulse oximeter** measure? | SpO₂

**Percentage of hemoglobin** that is saturated with oxygen in arterial blood.

What is the target **SpO₂**?

\> 94%

List **causes** of erroneous **SpO₂** readings?

* bright light * patient movement * poor perfusion * nail polish * abnormal Hgb

# Define: carboxyhemoglobin

The amount of **carbon monoxide** loaded onto hemoglobin.

What are the **normal ABG values**?

* pH: **7.35-7.45** * PaO₂: **80-100 mmHg** * PaCo₂: **35-45 mmHg** * HCO₃: **22-26 mEq/L**

What does the **End-Tidal CO₂** measure? | EtCO₂

It measures **CO₂** in exhaled air.

What is the **normal EtCO₂**?

35-45 mmHg

# Define: normal waveform capnography

**Sudden increase** during exhalation, with a **gradual plateau** at the end of exhalation.

During **hyperventilation**, the EtCO₂ reading \_\_\_\_\_\.

decreases ## Footnote Pt is blowing off CO₂.

During **hypoventilation**, the EtCO₂ reading \_\_\_\_\_\.

increases ## Footnote Pt is retaining excess CO₂.

How is the patient placed in the **recovery position**?

Left Lateral Recumbent position

What are the procedures for performing the **Head Tilt Chin Lift**?

1. Ensure the pt is in the supine position. 2. One hand is on the forehead, and the other is under the jaw. 3. Lift the chin to raise the entire mandible, opening the airway.

Patient Assessment - Respiratory Flashcards

Learn proper Assessment techniques for Airway, Respiration and Ventilatory emergencies (46 cards)