Lesson 1 Ventilation 13 Demonstrate concepts and skills of the following in a clinicallab setting a Patient Positioning b Transfers and Ambulation including injury ID: 775490
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Unit 2: Artificial Ventilation
Lesson 1: Ventilation
Slide213) Demonstrate concepts and skills of the following in a clinical/lab setting: a. Patient Positioning b. Transfers and Ambulation (including injury prevention and body mechanics) c. O2 Assessment and Administration (including fire safety) d. BLS (Basic Life Support)11) Outline the gross normal structure and function of all body systems and summarize appropriate medical text(s) in order to relate signs and symptoms of common diseases and disorders associated with each. c. cardiovascular and respiratory systems
Standard
Slide3Lesson 1 – Ventilation
Ventilation - movement of air in and out of lungsOxygenation – getting oxygen molecules into bloodstreamNo ventilation = no oxygenation
Slide4Lesson 1 – Ventilation
Adequate Ventilation: two ways to determine
Respiratory rate
Rate of breathing
Count breaths
Tidal volume
Depth of breathing
Deep/shallow/normal
Slide5Lesson 1 – Ventilation
Minute VolumeAmount of air breathed in and out in one minuteDetermined by respiratory rate and tidal volume
Slide6Lesson 1 – Ventilation
Dead Air Space
Area of lungs outside alveoli
Respiration does not take place
About 30 percent of air inhaled remains in dead air space
Slide7Lesson 1 – Ventilation
Alveolar VentilationAmount of air breathed in one minute used for respirationCalculated using tidal volume, dead air space and respiratory rate
Slide8Lesson 1 – Ventilation
Artificial Ventilation
Process of forcing air into patient’s lungs
Used if patient unable to ventilate
Used if ventilations inadequate
Slide9Unit 2: Artificial Ventilation
Lesson 2: Artificial Ventilation
Slide1013) Demonstrate concepts and skills of the following in a clinical/lab setting: a. Patient Positioning b. Transfers and Ambulation (including injury prevention and body mechanics) c. O2 Assessment and Administration (including fire safety) d. BLS (Basic Life Support)11) Outline the gross normal structure and function of all body systems and summarize appropriate medical text(s) in order to relate signs and symptoms of common diseases and disorders associated with each. c. cardiovascular and respiratory systems
Standard
Slide11Lesson 2 – Artificial Ventilation
Artificial Ventilation
Process of forcing air into patient’s lungs
Also called
positive pressure ventilation
Used when:
patient unable to ventilate
ventilations inadequate
Patient must have a pulse
Slide12Lesson 2 – Artificial Ventilation
Inadequate Ventilation indications:Abnormal respiratory rateInadequate tidal volumeLabored breathingAbnormal breathing soundsVaried depths of breathing
Slide13Lesson 2 – Artificial Ventilation
Inadequate Oxygenation
Without ventilation, no oxygenation
Hypoxia
Indications of inadequate oxygenation
Slide14Lesson 2 – Artificial Ventilation
Methods Mouth-to-maskBag-valve maskDemand-valveAutomatic transport ventilatorsFollow state guidelines
Slide15Lesson 2 – Artificial Ventilation
Basic Considerations
Infection control precautions
Don’t use mouth-to-mouth unless no other means available
Airway must be clear and open
Mask must be sealed properly
Slide16Lesson 2 – Artificial Ventilation
Effective VentilationsRate and tidal volume must be sufficient and steadyRateAdults 10-12/minPediatric 12-20/minTidal volumeChest should rise and fall
Slide17Lesson 2 – Artificial Ventilation
Over-Ventilation
Rate too fast and/or tidal volume too high
May cause:
Hypotension
Gastric distention
Vomiting
Pneumothorax
Decreased blood flow during CPR
Ways to avoid over-ventilation
Slide18Lesson 2 – Artificial Ventilation
Cardiac Output during Artificial VentilationNormal ventilation: negative pressureArtificial ventilation: positive pressureCardiac output decreasesBlood pressure decreases
Slide19Unit 2: Artificial Ventilation
Lesson 3: Mouth-to-Mask Ventilation
Slide2013) Demonstrate concepts and skills of the following in a clinical/lab setting: a. Patient Positioning b. Transfers and Ambulation (including injury prevention and body mechanics) c. O2 Assessment and Administration (including fire safety) d. BLS (Basic Life Support)11) Outline the gross normal structure and function of all body systems and summarize appropriate medical text(s) in order to relate signs and symptoms of common diseases and disorders associated with each. c. cardiovascular and respiratory systems
Standard
Slide21Lesson 3 – Mouth-to-Mask Ventilation
Quickest and easiest way to begin artificial ventilationUses pocket mask
Slide22Lesson 3 – Mouth-to-Mask Ventilation
The Pocket Mask features:
Effective infection control
One-way valve
Clear to see mouth and nose
Strap to go around head
Oxygen inlet
Various sizes
Slide23Lesson 3 – Mouth-to-Mask Ventilation
Providing OxygenAmbient air about 21% oxygenExhaled air about 16% oxygenSupplemental oxygen:Oxygen tank may be used for up to 50% oxygenBag-valve methodDemand-valve method
Slide24Lesson 3 – Mouth-to-Mask Ventilation
The E-C Method
Form airtight seal with mask
Finger placement
Also called
C&E method
or
C-clamp method
Slide25Unit 2: Artificial Ventilation
Lesson 4: Bag-Valve Ventilation
13) Demonstrate concepts and skills of the following in a clinical/lab setting: a. Patient Positioning b. Transfers and Ambulation (including injury prevention and body mechanics) c. O2 Assessment and Administration (including fire safety) d. BLS (Basic Life Support)11) Outline the gross normal structure and function of all body systems and summarize appropriate medical text(s) in order to relate signs and symptoms of common diseases and disorders associated with each. c. cardiovascular and respiratory systems
Standard
Slide27Lesson 4 – Bag-Valve Mask Ventilation
Used for patients not breathing or breathing inadequately
Made of face mask attached to ventilation bag
When bag squeezed, air is forced into patient
Slide28Lesson 4 – Bag-Valve Mask Ventilation
The Bag-Valve Mask features:Several sizes availableClear plasticNon-rebreather valveVentilation bag is self-refilling and several sizes availableTubing, inlet and reservoir can be attached to an oxygen source
Slide29Lesson 4 – Bag-Valve Mask Ventilation
One and Two-Person Rescues
One-person method tiring and difficult
Two-person method is more efficient and preferred
Slide30Lesson 4 – Bag-Valve Mask Ventilation
Bag-Valve Mask vs. Mouth-to-MaskMouth-to-MaskMore consistent tidal volumesPreferred when one-person rescueBag-Valve MaskBetter seal, higher levels of oxygen providedPreferred when two-person rescue
Slide31Unit 2: Artificial Ventilation
Lesson 5: Cricoid Pressure
Slide3213) Demonstrate concepts and skills of the following in a clinical/lab setting: a. Patient Positioning b. Transfers and Ambulation (including injury prevention and body mechanics) c. O2 Assessment and Administration (including fire safety) d. BLS (Basic Life Support)11) Outline the gross normal structure and function of all body systems and summarize appropriate medical text(s) in order to relate signs and symptoms of common diseases and disorders associated with each. c. cardiovascular and respiratory systems
Standard
Slide33Lesson 5 – Cricoid Pressure
Cricoid PressurePressure applied to cricoid cartilageSellick ManeuverGuides air into trachea instead of esophagus
Slide34Lesson 5 – Cricoid Pressure
The Cricoid Cartilage
Located between larynx and trachea
Blocks esophagus when pressed backward
Slide35Lesson 5 – Cricoid Pressure
ConsiderationsShould only be applied to unresponsive patientsRequires use of an additional emergency providerShould prevent vomiting but be prepared
Slide36Unit 2: Artificial Ventilation
Lesson 6: Demand-Valve Ventilation
Slide3713) Demonstrate concepts and skills of the following in a clinical/lab setting: a. Patient Positioning b. Transfers and Ambulation (including injury prevention and body mechanics) c. O2 Assessment and Administration (including fire safety) d. BLS (Basic Life Support)11) Outline the gross normal structure and function of all body systems and summarize appropriate medical text(s) in order to relate signs and symptoms of common diseases and disorders associated with each. c. cardiovascular and respiratory systems
Standard
Slide38Lesson 6 – Demand-Valve Ventilation
Only EMTs or higher level EMS providers can use100% oxygen delivered to patient through oxygen-powered valve and maskAlso called flow-restricted, oxygen-powered ventilation device (FROPVD)
Slide39Lesson 6 – Demand-Valve Ventilation
Demand-Valve Concerns
Uses pressurized oxygen
Pressure might be too strong and cause:
Gastric distension
Barotrauma
Use with great care
Shouldn’t use on chest trauma or pediatric patients
Slide40Lesson 6 – Demand-Valve Ventilation
Advantages:Can be done by one rescuerReduces fatigue to rescuerDelivers 100% oxygenIdeal for patients with pulmonary edemaDisadvantages:Can’t “feel” airImproper use may injureRequires oxygen sourceCan only be used on adults
Slide41Lesson 6 – Demand-Valve Ventilation
Demand-Valve Device features:
Flow rate no greater than 100% at 40 LPM
Pressure relief valve
Alarm
On/off trigger conveniently positioned
Valve to release patient’s exhaled air
Slide42Lesson 6 – Demand-Valve Ventilation
Alternate MethodsTwo-person methodCan be used for rescue breaths during CPR
Slide43Unit 2: Artificial Ventilation
Lesson 7: Automatic Transport Ventilator
Slide4413) Demonstrate concepts and skills of the following in a clinical/lab setting: a. Patient Positioning b. Transfers and Ambulation (including injury prevention and body mechanics) c. O2 Assessment and Administration (including fire safety) d. BLS (Basic Life Support)11) Outline the gross normal structure and function of all body systems and summarize appropriate medical text(s) in order to relate signs and symptoms of common diseases and disorders associated with each. c. cardiovascular and respiratory systems
Standard
Slide45Lesson 7 – Automatic Transport Ventilator
Automatic Transport Ventilator (ATV)Automatically controls respiratory rate and tidal volumeOnly for EMTs and higher levels of EMS providersFollow state guidelines when using ATV
Slide46Lesson 7 – Automatic Transport Ventilator
Features of ATVs
Small, lightweight, portable and durable
Able to deliver 100% oxygen
Able to connect to masks and endotracheal tubes
Adjustable respiratory rate and tidal volume
Slide47Lesson 7 – Automatic Transport Ventilator
Select Respiratory Rate10 BPM for adults20 BPM for childrenSelect Tidal VolumeCalculate using patient’s estimated body weightStart at low end of rangeShouldn’t be raised above 800 ml
Slide48Lesson 7 – Automatic Transport Ventilator
Advantages
Steady, controlled ventilation
Can be used by one rescuer
One rescuer can apply cricoid pressure if needed
Slide49Lesson 7 – Automatic Transport Ventilator
DisadvantagesRescuer unable to “feel” ease of air entering lungsImproper use may cause injuryRequires oxygen sourceMust have backup method availableCan’t be used on children under 5