Slow, shallow, irregular respirations or occasional gasping breaths; sometimes seen in dying patients.
The upper airway tract or the passage above the larynx, which includes the nose, mouth, and throat.
The volume of air that reaches the alveoli. It is determined by subtracting the amount of dead space air from the tidal volume.
American Standard System
A safety system for large oxygen cylinders, designed to prevent the accidental attachment of a regulator to a cylinder containing the wrong type of gas.
The metabolism that takes place in the absence of oxygen; the principle product is lactic acid.
In the context of airway, the introduction of vomitus or other foreign material into the lungs.
Irregular, ineffective respirations that may or may not have an identifiable pattern.
automatic transport ventilator (ATV)
A ventilation device attached to a control box that allows the variables of ventilation to be set. It frees the EMT to perform other tasks while the patient is being ventilated.
A device with a one-way valve and a face mask attached to a ventilation bag; when attached to a reservoir and connected to oxygen, it delivers more than 90% supplemental oxygen.
A protective item, such as a pocket mask with a valve, that limits exposure to a patient's body fluids.
Subdivision of the smaller bronchi in the lungs; made of smooth muscle and dilate or constrict in response to various stimuli.
Monitor the levels of O2, CO, and the pH of the cerebrospinal fluid and then provide feedback to the respiratory centers to modify the rate and depth of breathing based on the body's needs at any given time.
continuous positive airway pressure (CPAP)
A method of ventilation used primarily in the treatment of critically ill patients with respiratory distress; can prevent the need for endotracheal intubation.
Pressure on the cricoid cartilage; applied to occlude the esophagus to inhibit gastric distention and regurgitation of vomitus in the unconscious patient.
The portion of the tidal volume that does not reach the alveoli and thus does not participate in gas exchange.
A process in which molecules move from an area of higher concentration to an area of lower concentration.
The passive part of the breathing process in which the diaphragm and the intercostal muscles relax, forcing air out of the lungs.
The exchange of gases between the lungs and the blood cells in the pulmonary capillaries; also called pulmonary respiration.
A normal reflex mechanism that causes retching; activated by touching the soft palate or the back of the throat.
A condition in which air fills the stomach, often as a result of high volume and pressure during artificial ventilation.
The space in between the vocal cords that is the narrowest portion of the adult's airway; also called the glottic opening.
good air exchange
A term used to distinguish the degree of distress in a patient with a mild airway obstruction. With good air exchange, the patient is still conscious and able to cough forcefully, although wheezing may be heard.
head tilt-chin lift maneuver
A combination of two movements to open the airway by tilting the forehead back and lifting the chin; not used for trauma patients.
A "backup system" to control respiration; senses drops in the oxygen level in the blood.
Bypassing of oxygen-poor blood past nonfunctional alveoli to the left side of the heart.
Technique to open the airway by placing the fingers behind the angle of the jaw and bringing the jaw forward; used for patients who may have a cervical spine injury.
Breathing that requires greater than normal effort; may be slower or faster than normal and usually requires the use of accessory muscles.
A complex structure formed by many independent cartilaginous structures that all work together; where the upper airway ends and the lower airway begins; also called the voice box.
manually triggered ventilation device
A fixed flow/rate ventilation device that delivers a breath every time its button is pushed; also referred to as a flow-restricted, oxygen-powered ventilation device.
Space within the chest that contains the heart, major blood vessels, vagus nerve, trachea, major bronchi, and esophagus; located between the two lungs.
metabolism (cellular respiration)
The biochemical processes that result in production of energy from nutrients within the cells.
mild airway obstruction
Occurs when a foreign body partially obstructs the patient's airway. The patient is able to move adequate amounts of air, but also experiences some degree of respiratory distress.
The volume of air moved through the lungs in 1 minute minus the dead space; calculated by multiplying tidal volume (minus dead space) and respiratory rate; also referred to as minute volume.
An oxygen-delivery device in which oxygen flows through two small, tubelike prongs that fit into the patient's nostrils; delivers 24% to 44% supplemental oxygen, depending on the flow rate.
nasopharyngeal (nasal) airway
Airway adjunct inserted into the nostril of an unresponsive patient, or a patient with an altered level of consciousness who is unable to maintain airway patency independently.
The nasal cavity; formed by the union of facial bones and protects the respiratory tract from contaminants.
A combination mask and reservoir bag system that is the preferred way to give oxygen in the prehospital setting; delivers up to 90% inspired oxygen and prevents inhaling the exhaled gases (carbon dioxide).
oropharyngeal (oral) airway
Airway adjunct inserted into the mouth of an unresponsive patient to keep the tongue from blocking the upper airway and to facilitate suctioning the airway, if necessary.
Forms the posterior portion of the oral cavity, which is bordered superiorly by the hard and soft palates, laterally by the cheeks, and inferiorly by the tongue.
The process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs.
The term used to describe the amount of gas in air or dissolved in fluid, such as blood.
A system established for portable cylinders to ensure that a regulator is not connected to a cylinder containing the wrong type of gas.
poor air exchange
A term used to describe the degree of distress in a patient with a mild airway obstruction. With poor air exchange, the patient often has a weak, ineffective cough, increased difficulty breathing, or possible cyanosis and may produce a high-pitched noise during inhalation (stridor).
positive end-expiratory pressure (PEEP)
Mechanical maintenance of pressure in the airway at the end of expiration to increase the volume of gas remaining in the lungs.
An assessment tool that measures oxygen saturation of hemoglobin in the capillary beds.
A side-lying position used to maintain a clear airway in unconscious patients without injuries who are breathing adequately.
A technique that is used with intubation in which pressure is applied on either side of the cricoid cartilage to prevent gastric distention and aspiration and allow better visualization of vocal cords; also called cricoid pressure.
severe airway obstruction
Occurs when a foreign body completely obstructs the patient's airway. Patients cannot breathe, talk, or cough.
An opening through the skin and into an organ or other structure; a stoma in the neck connects the trachea directly to the skin.
A liquid protein substance that coats the alveoli in the lungs, decreases alveolar surface tension, and keeps the alveoli expanded; a low level in a premature infant contributes to respiratory distress syndrome.
A life-threatening collection of air within the pleural space; the volume and pressure have both collasped the involved lung and caused a shift of the mediastinal structures to the opposite side.
The amount of air (in milliliters) that is moved in or out of the lungs during one breath.
Large, semirigid suction tips recommended for suctioning the pharynx; also called Yankauer tips.
Exchange of air between the lungs and the environment, spontaneously by the patient or with assistance from another person, such as an EMT.
The amount of air that can be forcibly expelled from the lungs after breathing in as deeply as possible.
Thin white bands of tough muscular tissue that are lateral borders of the glottis and serve as the primary center for speech production.
The production of whistling sounds during expiration such as occurs in asthma and bronchiolitis.
An ECG that uses 12 leads attached to the patient's skin; these include the limb leads and chest leads
A sealed hub on an administration set designed for sterile access to the intravenous fluid
The complete absence of any electrical cardiac activity, appearing as a straight or almost straight line on an ECG strip
The act of viewing the electrical activity of the heart through the use of an ECG machine or cardiac monitor
The cutting of the catheter by the needle during improper rethreading of the catheter with the needle; the severed piece can then enter the circulatory system
The leads that are used only with a 12-lead ECG and must be placed exactly; includes leads V1, V2, V3, V4, V5, and V6
A multilumen airway device that consists of a single tube with two lumens, two balloons, and two ventilation ports; an alternative airway device if endotracheal intubation is not possible or has failed
The area of the administration set where fluid accumulates so that the tubing remains filled with fluid
an electronic tracing of the heart's electrical activity through leads, which originate in the electrocardiograph machine and contain electrodes that attach to the patient's chest and/or limbs
electrical conduction system
A network of special cells in the heart through which an electrical current flows, causing contractions of the heart that produce pumping of blood
end-tidal carbon dioxide detectors
Plastic, disposable indicators that signal by color change when an endotracheal tube is in the proper place
Insertion of an endotracheal tube directly through the larynx between the vocal cords and into the trachea to maintain and protect an airway
An advanced airway adjunct that provides a channel directly into a patient's stomach, allowing for removal of gas, blood, and toxins and for instilling medications and nutrition
A measure of the interior diameter of the catheter, It is inversely proportional to the true diameter of the catheter
The escape of fluid into the surrounding tissue when the IV catheter is not in the vein
Intravenous solutions that do not cause a fluid shift into or out of the cell; examples include normal saline and lactated Ringer's solutions
laryngeal mask airway
An advanced airway device that is blindly inserted into the mouth to isolate the larynx for direct ventilation; consists of a tube and a mask or cuff that inflates to seal around the laryngeal opening
An instrument used to give a direct view of the patient's vocal cords during endotracheal intubation
The four leads used with a 4-lead ECG; placed on or close to the right arm, left arm, right leg, and left leg
An administration set named for the large orifice between the piercing spike and the drip chamber; allows for rapid fluid flow into the vascular system
An administration set named for the small orifice between the piercing spike and the drip chamber; allows for carefully controlled fluid flow and is ideally suited for medication administration
Advanced airway devices, such as the esophageal tracheal Combitube and the pharyngeotracheal lumen airway, that have multiple tubes to aid in ventilation and will work whether placed in the trachea or esophagus
normal sinus rhythm
A rhythm that has consistent P waves, consistent P-R intervals, and a regular heart rate of between 60 and 100 beats/min
pharyngeotracheal lumen airway
A multilumen airway that consists of two tubes, two masks, and a bite block
The hard, sharpened plastic spike on the end of the administration set designed to pierce the sterile membrane of the intravenous bag
Anatomic location for intraosseous catheter insertion; the wide portion of the tibia located directly below the knee
saline locks (buff caps)
Special types of intravenous apparatus, also called heparin caps and heparin locks
A technique that is used with intubation in which pressure is applied on either side of the cricoid cartilage to prevent gastric distention and aspiration and allow better visualization of vocal cords; also called cricoid pressure
A rhythm that has consistent P waves, consistent P-R intervals, and a regular heart rate that is less than 60 beats/min
A rhythm that has consistent P waves, consistent P-R intervals, and a regular heart rate that is more than 100 beats/min
STEMI (ST-segment elevation myocardial infarction)
Elevation of the ST segment of the 12-lead ECG that is likely evidence that the patient is having a heart attack
A moderate to severe complication affecting the systems of the body; after administration of medications, the reaction might be systemic
Disorganized, ineffective twitching of the ventricles, resulting in no blood flow and a state of cardiac arrest
A rapid heart rhythm in which the electrical impulse begins in the ventricle (instead of the atrium), which may result in inadequate blood flow and eventually deteriorate into cardiac arrest
The secondary muscles of respiration. They include the neck muscles (sternocleidomastoids), the chest pectoralis major muscles, and the abdominal muscles.
A method of assessing the level of consciousness by determining whether the patient is awake and alert, responsive to verbal stimuli or pain, or unresponsive; used principally early in the assessment process.
A test that evaluates distal circulatory system function by squeezing (blanching) blood from an area such as a nail bed and watching the speed of its return after releasing the pressure.
A noninvasive method that can quickly and efficiently provide information on a patient's ventilatory status, circulation, and metabolism.
A component of air that typically makes up 0.3% of air at sea level; also a waste product exhaled during expiration by the respiratory system.
The reason a patient called for help; also, the patient's response to questions such as "What's wrong?" or "What happened?"
Capnometer or end-tidal carbon dioxide detectors are devices that use a chemical reaction to detect the amount of carbon dioxide present in expired gases by changing colors (qualitative measurement rather than quantitative).
A grating or grinding sensation caused by fractured bone ends or joints rubbing together; also air bubbles under the skin that produce a crackling sound or crinkly feeling.
A mnemonic for assessment in which each area of the body is evaluated for Deformities, Contusions, Abrasions, Punctures/penetrations, Burns, Tenderness, Lacerations, and Swelling.
The pressure that remains in the arteries during the relaxing phase of the heart's cycle (diastole) when the left ventricle is at rest.
A type of physical assessment that is typically performed on patients who have sustained nonsignificant mechanisms of injury or on responsive medical patients. This type of examination is based on the chief complaint and focuses on one body system or part
Damage to tissues as the result of exposure to cold; frozen or partially frozen body parts are frostbitten
A systematic head-to-toe examination that is performed during the secondary assessment on a patient who has sustained a significant mechanism of injury, is unconscious, or is in critical condition (Pg 291 - 295)
The overall initial impression that determines the priority for patient care; based on the patient's surroundings, the mechanism of injury, signs and symptoms, and the chief complaint
The time from injury to definitive care, during which treatment of shock and traumatic injuries should occur because survival potential is best
Involuntary muscle contractions (spasms) of the abdominal wall in an effort to protect an inflamed abdomen; a sign of peritonitis
A step within the patient assessment process that provides detail about the patient's chief complaint and an account of the patient's signs and symptoms
A condition in which the internal body temperature falls below 95°F (35°C), usually as a result of prolonged exposure to cool or freezing temperatures
incident command system (ICS)
A system implemented to manage disasters and mass-casualty incidents in which section chiefs, including finance, logistics, operations, and planning, report to the incident commander
Breathing that requires greater than normal effort; may be slower or faster than normal and usually requires the use of accessory muscles
mechanism of injury (MOI)
The way in which traumatic injuries occur; the forces that act on the body to cause damage
An abbreviation for key terms used in evaluating a patient's pain: Onset, Provocation or Palliation, Quality, Region/radiation, Severity, and Timing of pain
The mental status of a patient as measured by memory of person (name), place (current location), time (current year, month, and approximate date), and event (what happened)
The motion of the portion of the chest wall that is detached in a flail chest; the motion—in during inhalation, out during exhalation—is exactly the opposite of normal chest wall motion during breathing
Circulation of blood within an organ or tissue in adequate amounts to meet current needs of the cells
personal protective equipment (PPE)
Clothing or specialized equipment that provides protection to the wearer
A step within the patient assessment process that identifies and initiates treatment of immediate and potential life threats
The pressure wave that occurs as each heartbeat causes a surge in the blood circulating through the arteries
An assessment tool that measures oxygen saturation of hemoglobin in the capillary beds
A crackling, rattling breath sound that signals fluid in the air spaces of the lungs; also called crackles
A step within the patient assessment process that is performed at regular intervals to identify and treat changes in a patient's condition, A patient in unstable condition should be reassessed every 5 minutes, whereas a patient in stable condition should be reassessed every 15 minutes
The way in which a patient responds to external stimuli, including verbal stimuli (sound), tactile stimuli (touch), and painful stimuli
A brief history of a patient's condition to determine signs and symptoms, allergies, medications, pertinent past history, last oral intake, and events leading to the injury or illness
A step within the patient assessment process that involves a quick assessment of the scene and the surroundings to provide information about scene safety and the mechanism of injury or nature of illness before you enter and begin patient care
The tough, fibrous, white portion of the eye that protects the more delicate inner structures
A step within the patient assessment process in which a systematic physical examination of the patient is performed, The examination may be a systematic full-body scan or a systematic assessment that focuses on a certain area or region of the body, often determined through the chief complaint
Respirations that are charcterized by little movement of the chest wall (reduced tidal volume) or poor chest excursion
An upright position in which the patient's head and chin are thrust slightly forward to keep the airway open
Protective measures that have traditionally been developed by the Centers for Disease Control and Prevention for use in dealing with objects, blood, body fluids, and other potential exposure risks of communicable disease
A characteristic crackling sensation felt on palpation of the skin caused by the presence of air in soft tissues
The increased pressure in an artery with each contraction of the ventricles (systole)
The amount of air (in milliliters) that is moved in or out of the lungs during one breath
The process of sorting patients based on the severity of injury and medical need to establish treatment and transportation priorities
An upright position in which the patient leans forward onto two arms stretched forward and thrusts the head and chin forward
two- to three-word dyspnea
A severe breathing problem in which a patient can speak only two to three words at a time without pausing to take a breath