Instructional Guide

1. Major Structures of the Respiratory System (1-1)
   
   1. Components of the System
      
      1. Nose and mouth
         
      2. Pharynx
         
         1. Oropharynx
            
         2. Nasopharynx
            
      3. Epiglottis
         
      4. Trachea (windpipe)
         
      5. Cricoid cartilage
         
      6. Larynx (voice box)
         
      7. Bronchi
         
         1. bronchioles
            
         2. alveoli
            
      8. Lungs
         
      9. Diaphragm
         
   2. Importance of Proper Ventilation
      
      1. Oxygen exchange through alveoli
         
      2. Circulation of oxygen to cells
         
      3. Oxygen/carbon dioxide exchange through capillaries
         
      4. Respiratory Rates
         
         1. Adult - 12 to 20/minute
            
         2. Child - 15 to 30/minute
            
         3. Infant - 25 to 50/mintue
            
2. Opening and Maintaining the Airway (1-2)
   
   1. Adult
      
      1. Head-tilt, chin lift (no spinal injury)
         
      2. Jaw thrust (spinal injury suspected)
         
      3. Measure and insert oropharyngeal or nasopharyngeal airway
         
         1. Oropharyngeal measured from corner of mouth to tip of earlobe
            
         2. (Alternate measure from center of mouth to angle of Jaw)
            
         3. Insert oropharyngeal airway with tip toward roof of mouth and rotate after past uvula
            
         4. Nasopharyngeal - use largest that will fit in nostril without force - usually can judge by size of patient’s little finger
            
         5. Insert nasopharyngeal by pushing tip of nose upward. Place in right nostril with bevel toward septum.
            
   2. Child
      
      1. Head-tilt, chin lift - NEUTRAL ALIGNMENT
         
      2. Jaw Thrust
         
      3. Measure and insert an oropharyngeal airway.
         
         1. Measure same as for adult.
            
         2. To insert, push down on tongue and pull up on jaw. Insert with tip pointing toward the tongue and throat.
            
   3. Infant - NEUTRAL ALIGNMENT
      
      1. Head-tilt, chin-lift (no spinal injury)
         
      2. Jaw Thrust (suspected spinal injury)
         
      3. Measure and insert an oropharyngeal airway.
         
         1. Measure same as for adult.
            
         2. To insert, push down on tongue and pull up on jaw. Insert with tip pointing toward the tongue and throat.
            
3. Suctioning (1-3)
   
   1. Purpose
      
      1. Remove blood, liquids, and food particles.
         
      2. Can be used to remove teeth and other foreign bodies.
         
      3. When gurgling sound is heard.
         
   2. Types of Units
      
      1. Suction devices are mounted or portable - electrical and hand operated
         
      2. Use hard/rigid or soft catheters.
         
   3. Proper Technique
      
      1. Hard catheters should only be inserted as far as you can see to suction mouth and oropharynx. Use rigid catheter for infant and children.
         
      2. Soft catheters used for suctioning where a rigid catheter cannot be used - measure so that it is only inserted as far as base of tongue.
         
      3. Suction for no more than 15 seconds at a time. Shorter time for infants and children - no more than a few seconds.
         
      4. If thick secretions can not be suctioned, roll patient and clear oropharynx.
         
4. Ventilating with Bag Valve Mask (1-4)
   
   1. One Person Bag Valve Mask
      
      1. Use correct size for patient - should be used with supplemental oxygen.
         
      2. Kneel at patient’s head.
         
      3. Place top of mask over bridge of patient’s nose then lower mask over mouth and upper chin.
         
      4. Use ring and little fingers to maintain seal and head-tilt, chin-lift.
         
      5. Squeeze the bag once every 5 seconds for an adult, once every 3 seconds for a child or infant.
         
      6. Release pressure and let patient exhale passively.
         
   2. Two Person Bag Valve Mask
      
      1. Preferred method if have two rescuers.
         
      2. First rescuer maintains seal using two hands.
         
      3. Second rescuer squeezes the bag with two hands.
         
      4. Allows better maintenance of seal and aids ventilations.
         

Review:

Review of Respiratory System and Its Function

1. System Components and Importance of Proper Ventilation
2. Opening and Maintaining Airways of Adults, Children, and Infants
3. Suctioning
4. Performing Artificial Ventilations

Remotivation:

Assignment:

Evaluation:

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