NREMT Exam Airway, Respiration & Ventilation Module
MECHANISM OF BREATHING
In order to understand the pathophysiology of respiratory emergencies, as well as how different treatments will affect the respiratory system, we must first understand the physics and physiology of ventilation and respiration. The mechanics of breathing are what allows the body to inhale air containing oxygen, exchange this oxygen for carbon dioxide in the lung tissue and exhale the carbon dioxide which is a byproduct of energy consumption and metabolism. These mechanisms, if disrupted, can lead to life threatening complications as the body requires this exchange to survive. Understanding the mechanics of breathing sets the foundation to understanding how the body works and sustains life.
As with all things in medicine, a good assessment is what sets the stage for appropriate diagnosis and treatments. Airway emergencies are some of the most common emergencies seen by first responders and carry high morbidity and mortality if not addressed rapidly. In order to properly intervene to stabilize or protect an airway, you must be able to assess the airway quickly and efficiently. In this module we cover a systematic approach to assessing your patient’s airway.
Respiratory emergencies are some of the most common true emergencies encountered by first responders. Rapid decompensation can occur without appropriate identification and treatment, and so a review of the most common respiratory emergencies seen in the field and understanding their underlying pathophysiology is key. As you move through this section, pay attention to overlying themes in assessment and treatment such as early oxygen delivery and frequent reassessment of respiratory status.
Management of a patient’s airway is the first and most important step in emergency response and treatment. Patients with obstructed airways, respiratory failure or respiratory distress require that the first responder act quickly and with confidence to secure the airway and support ventilation. In this module we cover a systematic approach to airway management with an overview of the tools that can be utilized to maintain and support the airway and patient ventilation.
Endotracheal intubation remains the gold standard for securing a patient’s airway both in the field and in the hospital. Intubation, however, is an invasive procedure with inherent risks and dangers if not performed correctly. This requires that the first responder be able to not only properly perform intubation but also understand indications, contraindications and proper equipment use.
Capnography is the measurement of carbon dioxide concentrations in exhaled air. Capnography can be used to assess a patient’ ventilatory status, the success of intubation and the adequacy of CPR. In this lecture we will review how to utilize capnography in patient assessment and how to read a capnogram which will aid the first responder in being able to more quickly and efficiently manage patients with ventilatory issues.