Airway Ventilation Shock - Illinois Network for ：通气和减震伊利诺斯网络.pptVIP

Airway/VentilationShock Jami Windhorn, RN BSN CPN TNCC ENPC Objectives Identify Airway and Ventilation Issues in Trauma Patient Describe Nursing Assessment and Intervention of the Trauma Patient Identify Types of Shock Describe Signs and Symptoms of Shock Discuss Nursing Assessment and Interventions for Shock UpperAirway Anatomy Mouth Nose Pharynx Oropharynx Nasopharynx Epiglottis Trachea Lower Respiratory Anatomy Cricoid Cartilage Larynx Bronchi Lungs Pleura/Pleural Space Diaphragm Ventilation Inhalation * Diaphragm moves down, ribs move up and out, air flows in Exhalation * Diaphragm moves up, ribs move down and in, air flows out Gas exchange occurs to oxygenate the body Airway Assessment Obstruction * Tongue * Loose Teeth * Blood/Vomit * Foreign Body * Edema Patient History Type of Trauma? Burn? Pre-Existing Respiratory Disease? Drugs? Smoking? Loss of Consciousness? Nursing Assessment:Airway Open airway – Head Tilt Chin Lift Maintain C-Spine Suction any blood, vomit or objects from airway Can the patient talk? Trauma to airway? Opening the Airway Airway Management Oral Airway Nasopharyngeal Airway Laryngeal Mask Airway Combitube King Airway Intubation If unable to maintain an open airway and patient is requiring Bag/Mask Ventilation, endotracheal intubation may be necessary RSI:Rapid Sequence Intubation The process of quickly inducing anesthesia (Sedation and Paralytics) in a patient in order to intubate Sedation is used to reduce anxiety Paralytics are used in a patient who is awake, has a gag reflex and is agitated or combative RSI Steps Preparation: Gather all supplies Preoxygenation Pretreatment: Atropine or Fluid Bolus Paralysis Protect and Position: Cricoid Pressure Proof of Placement Post-Intubation Management Tube Placement Confirmation Auscultate breath sounds Equal chest rise and fall Exhaled Carbon Dioxide detector “Gold is Good” Chest X-Ray Contraindicationsto RSI Hypotension Total upper airway obstruction