Assessment and Treatment of the Respiratory System

For the Paramedic Student

Heather Davis, MS, NREMT-P

Primary Assessment

Ensure Patency– open airway– airway adjunct

Assess for Sounds of Compromise– suction

Assess adequacy of Breathing Ventilate as Needed Administer Oxygen as Needed

Secondary Assessment

History Physical Exam

– inspection– auscultation– palpation

Non-invasive Monitoring

Pulse oximetry Capnography

Basic Airway Management

Universal precautions Ensure patency Protect C-spine Perform manual maneuvers Use basic airway adjuncts Use advanced maneuvers for maximum

effectiveness

Manual Airway Maneuvers

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

Basic Mechanical Airways

Lift tongue off of oropharynx; used after manual maneuvers– Oropharyngeal– Nasopharyngeal

Advanced Airway Management

EOA EGTA PTL Combitube Endotracheal Intubation Digital Intubation Transillumination Intubation Nasotracheal Intubation

More Advanced Airways

Special Circumstances– Trauma patient– Children– RSI– Foreign body removal

Surgical Airways

Needle Cricothyrotomy Transtracheal Jet Ventilation

Suctioning

Equipment– suction units– suction catheters

Hazards– hypoxia, dysrythmias, vagal stimulation, gag

Techniques

Oxygenation

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

Nasal Cannula Simple Face Mask Nonrebreather Mask Venturi Mask

Ventilation

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

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

Any Questions?