Скачать или смотреть Airway and Respiratory Emergencies EXPLAINED

What You'll Learn/Key Takeaways:
When to Ventilate: Understand how to assess for inadequate breathing (shallow respirations, cyanosis, mottling) and when positive pressure ventilation (BVM) is the priority, even over bleeding control (unless it's a severe arterial bleed) or Narcan administration in an overdose.

Airway Obstruction (Choking):

Gurgling: Always means suctioning.

Partial Obstruction (conscious): Encourage coughing.

Complete Obstruction (conscious): Perform Heimlich maneuver.

Complete Obstruction (unconscious): Begin CPR, look for the object before breaths, and consider Magill forceps for paramedics.

Infants (less than 1 year): Use 5 back blows and 5 chest thrusts.

Respiratory Physiology & Acid-Base Balance:

Hering-Breuer Reflex: Prevents lung overinflation.

Respiratory Acidosis: Caused by slow/shallow breathing (CO2 retention).

Respiratory Alkalosis: Caused by fast breathing (excessive CO2 exhalation).

Distinguish respiratory pH issues from metabolic ones based on breathing effort.

Asthma: Involves bronchoconstriction, increased mucus, and airway edema. Learn about Status Asthmaticus (unresponsive to conventional treatment) and critical prehospital medications like Albuterol, Atrovent, corticosteroids (Solu-Medrol), and Magnesium Sulfate.

COPD: Characterized by chronic lung damage and air trapping. Understand hypoxic drive (breathing stimulated by low O2, not high CO2) and the cautious approach to oxygen administration. Recognize signs of COPD exacerbation. Note that epinephrine is generally avoided in COPD patients due to potential cardiac issues.

Pulmonary Embolism (PE): Suspect with sudden onset dyspnea, chest pain, and cyanosis unresponsive to oxygen. Prehospital care is supportive with oxygen; rapid transport is key.

Airway Management Complications:

BVM Limitations: Difficulty maintaining a seal, risk of gastric distension (leading to vomiting/aspiration).

Endotracheal Tube Confirmation: End-tidal capnography (waveform) is the most reliable method.

Patient "Bucking" the Tube: Administer benzodiazepines (sedation).

Cricothyrotomy: Performed when other airway methods fail or with severe facial/neck trauma. Learn about Open Cricothyrotomy and Needle Cricothyrotomy (a temporary measure that requires specialized equipment).

Timestamps:
0:00 - Paramedic Review Intro
0:31 - When to Ventilate & Prioritizing Life Threats
6:41 - Gurgling Respirations & Suctioning
7:39 - Choking (Adult/Child)
11:16 - Choking (Infant)
13:13 - Hering-Breuer Reflex
13:58 - Respiratory Acidosis vs. Alkalosis
17:27 - Asthma Pathophysiology & Status Asthmaticus
19:34 - Asthma Management (Medications)
21:55 - COPD: Pathophysiology & Hypoxic Drive
24:36 - COPD Exacerbation & Treatment Considerations
25:25 - Pulmonary Embolism (PE)
28:34 - Airway Management: BVM Limitations
30:05 - ET Tube Confirmation (Capnography)
31:07 - Managing a "Bucking" Tube
32:04 - Cricothyrotomy (Open vs. Needle)

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