FISDAP FINAL
BVM Respiratory Rates..How do we determine adequate respiration? - ANS- theoretically less
than 8 or more than 25-ish
- assess via adequate chest rise/fall, skin signs, respiratory status.
- is patient getting job done on their one or do they need hel?
Wheezing - ANSHigh pitched on exhale
Lower airway obstruction (bronchioles)
Asthma + allergic reaction/anaphylaxis
RONCHI - ANSDenser fluid in lungs (pneumonia, cystic fibrosis, chronic bronchitis)
CRACKLES (RALES) - ANSFluid in lungs ("underwater")
Blood or water
CHF, PE
STRIDOR - ANSHigh pitched during inspiration
Upper airway obstruction
Croup, epiglottitis, anaphylaxis
Corrective action if no longer see chest rise/fall during PPV ventilations? - ANSReposition
airway
Supplemental O2 Flow Rates - ANSNC: 2-6 l/min
NRB: 10-15 l/min
BVM: 15-25 l/min
Nebulized breathing treatment: 6-8 l/min
Witness patient collapse..airway obstruction..first objective? - ANSCheck breathing pulse —>
begin compressions (active 911/AED if possible)
What to ask chokng patient? How to approach? - ANS"Are you choking?"
"Can you cough?" Keep coughing
Approach from front and go to back if need to perform abdominal thrusts
How to treat pt w/ Stoma with inadequate respirations? - ANSBVM
Pediatric mask w/ adult bag
Attach directly to stoma tube
Humidified oxygen candidates - ANSCroup
Epiglottitis
,Adults - long transport time, long term o2 therapy
"Hoarse" "dry" "something is stuck"
How to ask questions to patient w/ extreme SOB and what to ask? - ANSSimple yes/no
questions
How long has this been going on?
Acute vs chronic - acute more emergent
NPA - ANSTip of nose to ear lobe
IND: semiconscoius or conscious w/ intact gag reflex, any patient who doesn't tolerate OPA
CI: severe head injury w/ bleeding in nose, history of nasal fracture
OPA - ANSCorner of moth to ear lobe
IND: unresponsive w/o gag reflex, apneic patients being ventilated w/ BVM
CI: conscious pt, intact gag reflex, heavy oral trauma
TENSION PNEUMOTHORAX - ANSResults from ongoing/uncorrected pneumothorax
Increasing respiratory difficulty
Diminished/absent lung sounds on affected side
JVD + tracheal deviation to opposite side
SPONTANEOUS PNEUMOTHORAX - ANSAcute SOB
Diminished/absent lung sounds on affected side
Tall, thin males w/ history of smoking, asthma
Trauma, non-traumatic, exertion (i.e. heavy lifting)
PNEUMONIA - ANSInfection causing pus/mucous blocking bronchioles
Fever, productive cough (green/brown/yellowish)
Ronchi, wheeze, diminished lung sounds in affected lobes
Starts in one lobe and progresses
Chest pain (increased respiratory effort)
Back pain, body aches, night sweats
Dyspnea
Often in elderly, SNF, close quarters living
S/S CHRONIC BRONCHITIS - ANSExcessive mucuous productive — airway obstruction
"Blue bloaters"
Sputum production
Difficulty w/ inspiration
Overweight + cyanotic
Easily fatigued
S/S COPD - ANSEmphysema - "pink puffers"
Barrel chest
, Increased accessory muscle use
Thin appearance + tripod position
Digital clubbing, non productive cough
Wheezing + pursed lip breathing
Prolonged expiratory time
Easily fatigued
Constant fatigue
History of smoking!!!
***more likely to be on home oxygen therapy
Systole - ANSPressure during ventricular contraction (ejecting blood)
*you feel pulse during systole
Diastole - ANSPressure during heart relaxation (refilling with blood)
Pt regains pulses after use of AED, what do you assist with? - ANSVentilations (BVM)
Nitroglycerin contradindications - ANS5 - 5 mins apart
3 - no more than 3 doses
B - BP < 100 mmHg
A - altered LOC
S - sexual enhancement drugs w/in 48 hours
H - head injury
Possible stroke patient, what questions important to ask? - ANSWhen was the last time patient
was "normal"?
How long ago did this start?
Agonal respirations...course of action? - ANSCheck for airway obstruction
BVM assistance
Shock position - ANSSupine
Blankets over/under to retain body heat
What chamber fails that causes pulmonary edema? - ANSLeft ventricle
S/S CHF - ANSL - pulmonary edema (crackles/rales)
R - JVD, peripheral edema
Coughing, pink frothy sputum
PCD skin signs
Orthopnea
symptoms worse w/ exertion
2 arrythmia's AED will shock? - ANSV-fib
BVM Respiratory Rates..How do we determine adequate respiration? - ANS- theoretically less
than 8 or more than 25-ish
- assess via adequate chest rise/fall, skin signs, respiratory status.
- is patient getting job done on their one or do they need hel?
Wheezing - ANSHigh pitched on exhale
Lower airway obstruction (bronchioles)
Asthma + allergic reaction/anaphylaxis
RONCHI - ANSDenser fluid in lungs (pneumonia, cystic fibrosis, chronic bronchitis)
CRACKLES (RALES) - ANSFluid in lungs ("underwater")
Blood or water
CHF, PE
STRIDOR - ANSHigh pitched during inspiration
Upper airway obstruction
Croup, epiglottitis, anaphylaxis
Corrective action if no longer see chest rise/fall during PPV ventilations? - ANSReposition
airway
Supplemental O2 Flow Rates - ANSNC: 2-6 l/min
NRB: 10-15 l/min
BVM: 15-25 l/min
Nebulized breathing treatment: 6-8 l/min
Witness patient collapse..airway obstruction..first objective? - ANSCheck breathing pulse —>
begin compressions (active 911/AED if possible)
What to ask chokng patient? How to approach? - ANS"Are you choking?"
"Can you cough?" Keep coughing
Approach from front and go to back if need to perform abdominal thrusts
How to treat pt w/ Stoma with inadequate respirations? - ANSBVM
Pediatric mask w/ adult bag
Attach directly to stoma tube
Humidified oxygen candidates - ANSCroup
Epiglottitis
,Adults - long transport time, long term o2 therapy
"Hoarse" "dry" "something is stuck"
How to ask questions to patient w/ extreme SOB and what to ask? - ANSSimple yes/no
questions
How long has this been going on?
Acute vs chronic - acute more emergent
NPA - ANSTip of nose to ear lobe
IND: semiconscoius or conscious w/ intact gag reflex, any patient who doesn't tolerate OPA
CI: severe head injury w/ bleeding in nose, history of nasal fracture
OPA - ANSCorner of moth to ear lobe
IND: unresponsive w/o gag reflex, apneic patients being ventilated w/ BVM
CI: conscious pt, intact gag reflex, heavy oral trauma
TENSION PNEUMOTHORAX - ANSResults from ongoing/uncorrected pneumothorax
Increasing respiratory difficulty
Diminished/absent lung sounds on affected side
JVD + tracheal deviation to opposite side
SPONTANEOUS PNEUMOTHORAX - ANSAcute SOB
Diminished/absent lung sounds on affected side
Tall, thin males w/ history of smoking, asthma
Trauma, non-traumatic, exertion (i.e. heavy lifting)
PNEUMONIA - ANSInfection causing pus/mucous blocking bronchioles
Fever, productive cough (green/brown/yellowish)
Ronchi, wheeze, diminished lung sounds in affected lobes
Starts in one lobe and progresses
Chest pain (increased respiratory effort)
Back pain, body aches, night sweats
Dyspnea
Often in elderly, SNF, close quarters living
S/S CHRONIC BRONCHITIS - ANSExcessive mucuous productive — airway obstruction
"Blue bloaters"
Sputum production
Difficulty w/ inspiration
Overweight + cyanotic
Easily fatigued
S/S COPD - ANSEmphysema - "pink puffers"
Barrel chest
, Increased accessory muscle use
Thin appearance + tripod position
Digital clubbing, non productive cough
Wheezing + pursed lip breathing
Prolonged expiratory time
Easily fatigued
Constant fatigue
History of smoking!!!
***more likely to be on home oxygen therapy
Systole - ANSPressure during ventricular contraction (ejecting blood)
*you feel pulse during systole
Diastole - ANSPressure during heart relaxation (refilling with blood)
Pt regains pulses after use of AED, what do you assist with? - ANSVentilations (BVM)
Nitroglycerin contradindications - ANS5 - 5 mins apart
3 - no more than 3 doses
B - BP < 100 mmHg
A - altered LOC
S - sexual enhancement drugs w/in 48 hours
H - head injury
Possible stroke patient, what questions important to ask? - ANSWhen was the last time patient
was "normal"?
How long ago did this start?
Agonal respirations...course of action? - ANSCheck for airway obstruction
BVM assistance
Shock position - ANSSupine
Blankets over/under to retain body heat
What chamber fails that causes pulmonary edema? - ANSLeft ventricle
S/S CHF - ANSL - pulmonary edema (crackles/rales)
R - JVD, peripheral edema
Coughing, pink frothy sputum
PCD skin signs
Orthopnea
symptoms worse w/ exertion
2 arrythmia's AED will shock? - ANSV-fib
