Hypoventilation (resulting from respiratory rate and tidal volume).
Ventricular Septal Defect.
Hyperventilation.
Patent Ductus Arteriosus.
Ventilation and perfusion.
A combination of the clinical features of hypoxaemia and hypercapnia.
They may be asymptomatic or have few symptoms.
Low oxygen levels (Hypoxaemia), decreased haemoglobin, respiratory disease, and cardiovascular disease.
Alveolar ventilation.
Two lights.
Inadequate ventilation, self-splinting, atelectasis, possibility of infection.
Chest decompression.
It is a condition where air enters the pleural space through an opening in the chest wall, leading to lung collapse.
Usually very accurate for measuring oxygen saturation.
Clinically evident hypoxaemia.
It can help reduce the workload on the heart and improve overall quality of life.
Confusion, restlessness, agitation, combativeness, disorientation, listlessness, unconsciousness.
Supplemental oxygen.
Tachycardia and bradycardia (severe).
A deficiency of oxygen in the body’s cells and tissues.
Because it is very difficult to detect visually.
Air in the pleural space under pressure, causing mediastinal shift.
Infrared light.
Atrial Septal Defect.
Deoxy Hb absorbs more red light than infrared light.
Pulmonary contusion, pneumothorax, and internal organ damage.
It measures how much of hemoglobin is carrying oxygen.
Decreased venous return, diminishing preload, ultimately leading to compensation and shock.
Hypoxaemia.
Directly proportional.
Pts at risk of hypoxaemia, anaesthesia or invasive airway insertion, high risk patients, any pt with respiratory abnormalities, pts on specific drug therapies.
To improve oxygen levels in the blood and alleviate symptoms of hypoxia.
Supplemental oxygen.
Sustained external pressure of only 45 mmHg.
Lung tissue can extract oxygen from the distal airways and has a separate blood supply from the bronchial arteries.
It is proportional.
Ventricular Septal Defect.
Evidence of soft tissue injury to the chest, decreased air entry on the injured side, hyper resonance on the injured side, and changes in auscultatory signs and percussion proportional to the size of the pneumothorax.
Nonrebreather mask, nasal cannula, simple face mask, partial rebreather, venturi mask, nebuliser.
It is the presence of air in the pleural space.
Ambient light, false alarms, motion artifact, skin pigmentation, and low perfusion state.
Ischaemia.
A break in the continuity of a rib or sternum.
Evidence of soft tissue injury to the chest, decreased air entry on the injured side, hyporesonance, and clinical features of blood loss with increasing size of the haemothorax.
The one-way valve effect causes air to move into the pleural space but does not allow it to move out, leading to increased pressure greater than atmospheric.
The amount of light absorbed is proportional to the length of the path that the light has to travel in the absorbing substance.
They usually enlarge and remain air-filled without collapsing.
Oxygen saturation.
Assess the size of the pneumothorax and the need for a chest drain.
Yes.
Analgesia, IV if no contra-indications.
Ventilation-perfusion mismatch.
Evidence of soft tissue injury to the chest, haemoptysis, dyspnea, and blood visible in the endotracheal tube.
Tachypnea, dyspnea, tachycardia, pyrexia, pleuritic chest pain, distended jugular vein, hemoptysis.
Smoking and exposure to tobacco smoke.
Airway, Oxygenation & Ventilation.
The cardiac suppressant effects predominate, causing hypotension and bradycardia.
Due to respiratory movement.
Supplemental oxygen.
Blood clots that travel to the lungs from the legs or other parts of the body.
Hypoventilation or apnea.
Hypoxaemia.
Hypotension, cardiovascular collapse, tachyarrhythmias, cyanosis.
Carboxyhemoglobin, Methemoglobin, Anemia, Dyes, Nail polish.
Results in separation of the lung from the chest wall and variable degrees of atelectasis.
It will be the same as that seen with the oxy Hb absorbance curve.
Fluid and blood loss into the involved tissues.
CNS Respiratory Centres, influence of CO2 levels, various drugs, and raised intracranial pressure.
Infrared light.
Usually very sick.
CO2 levels can influence respiratory centres in conditions like COPD.
Due to their position beneath the thoracic cage.
Soft tissue injury, pain ranging from moderate to severe, and pain aggravated by respiratory movement.
Airway management, including intubation.
The ratio of ventilation to perfusion in the lungs.
When there is a threatened airway (usually LOC-related) or a need to ventilate the patient.
Causes include blunt or penetrating trauma, inhalation of harmful substances, and medical conditions such as pneumonia or pulmonary embolism.
Infrared light.
Haemoglobin, blood flow, and oxygen metabolism.
It is the presence of air in the pleural space without any associated trauma or underlying lung disease.
Ventilation/Perfusion.
It tends to decrease heart rate and myocardial contractility.
Because it is life-threatening.
Red light and infrared light absorption.
Resistance to air flow.
Penetrating chest trauma, such as a gunshot or stab wound.
Inability of the cell to metabolize oxygen.
The process of exchanging oxygen and carbon dioxide between the cells and the external environment.
Tachycardia, weak peripheral pulses, cool & pale skin, hypotension, decreased level of consciousness (LOC).
Oxygen deficient atmosphere.
Paradoxical movement and similar to rib fractures.
A chronic weakening and destruction of the walls of the terminal bronchioles and alveoli.
It decreases the ability of the patient to create negative intrathoracic pressure, leading to respiratory distress.
About 1500 ml.
To avoid over-infusing the patient.
Breakdown of the connective tissue structure of the terminal airways.
Rapid transport, oxygenation, and continual monitoring.
Inspired oxygen concentration and barometric pressure.
Red light.
A low arterial partial pressure of oxygen <80mmHg.
Directly proportional.
Cardiac arrest.
Breakdown of the connective tissue structure of the terminal airways.
80mmHg – 100mmHg.
Excess ventilation in proportion to perfusion.
Results in a pneumo- or haemothorax. If associated with a one-way valve effect, it can lead to the formation of a tension pneumothorax.
Open thoracic injury, blunt trauma to lung parenchyma, barotrauma due to PPV, or tracheobronchial injuries due to shearing forces.
Pain, tenderness, swelling, and difficulty breathing.
They become fewer but larger, which are less efficient and collapse more easily.
It measures oxygen saturation but not the amount of hemoglobin or blood flow to tissues.
Hypoventilation and, if respiratory muscle fatigue occurs, apnea.
Absorption.
Sudden drop in cardiac output and cardiac arrest.
A one-way valve dressing (three-sided occlusive dressing) to prevent air from entering the pleural space but allow air already there to exit.
Chest decompression (needle thoracentesis).
Occupational exposure to dust, pollution, or tobacco smoke.
It may be caused by blunt or penetrating trauma, or by barotrauma (pressure).
A blockage in one of the pulmonary arteries in your lungs.
Mainly a decrease in LOC (level of consciousness).
Concentration of the light absorbing substance, length of the light path, and the specific light absorption characteristics of the substance.
It causes an increase in heart rate and blood pressure.
Transport/Absorption.
Often sick people with little or no respiratory reserve to deal with additional insults. When they call the EMS, something must have changed from being stable to one deemed it necessary to call. For example, acute COPD exacerbations.
Bleeding in lung tissue, at the capillary level.
Depending on underlying injuries.
Stasis of blood flow, reduced mobility, and changes in blood coagulation.
They absorb red and infrared light differently.
By comparing the absorption of red light and infrared light by the blood.
Chronic cough in the presence of increased bronchial secretions.
Approximately 90 mmHg.
Cyanide poisoning and carbon monoxide poisoning.
Failure of maintenance of normal arterial blood gas partial pressures (i.e. PaO2 and PaCO2).
Exacerbations are characterized by increases in shortness of breath, wheezing, cough, and increased sputum production and purulence.
It indicates an imbalance between oxygen supply and demand.
Spleen.
Congenital enzyme deficiency.
In a normal V/Q mismatch, ventilation and perfusion are matched, allowing for efficient gas exchange.
Dalton’s Law.
For hypoventilation.
Due to the inability of oxygen to improve PAO2 in unventilated lung units.
35-70%.
The V/Q ratio decreases.
Around the ages of 30 and 40 years.
It increases intrathoracic pressure.
It decreases PaO2.
It increases intracranial pressure (ICP).
The enlarged alveoli are less efficient due to reduced surface area and are more prone to collapse due to obstruction.
Treat for hypoxemia.
Ventilation - Perfusion Mismatch.
Blunt trauma, and occasionally penetrating trauma.
V/Q mismatching from the atelectasis.
Diffuse obstruction to airflow within the lungs.
In a small number of cases, yes.
A defect in the chest wall that allows air to enter the thoracic space, often due to a penetrating injury presenting as an open or sucking chest wound.
Deoxyhemoglobin.
No, it is not a common symptom and not required for the diagnosis.
Roughly 4 litres per minute.
Air, bone marrow, and amniotic fluid.
It leads to bronchospasm.
The movement of ribs is very painful, which contributes to difficulty in ventilation.
Bag-valve-tube ventilation is another method of providing positive pressure ventilation.
By hyperventilation.
It develops without significant cough and sputum production.
A blood clot or other substance that has traveled from elsewhere in the body and blocks a blood vessel.
Gunshot, stabbing, impaled object.
Patients with severe respiratory distress, unstable vital signs, or suspected critical injuries require rapid hospital transport, while stable patients may receive on-scene care.
A fracture in two or more adjacent ribs in two or more places, causing instability of the chest wall and paradoxical movement in a spontaneously breathing patient.
Normal weight and body build.
It decreases venous return.
It reduces surfactant production and predisposes the distal region to atelectasis.
Patients with unstable vital signs or severe symptoms requiring immediate intervention.
Inflammation and immune response.
Many critical organs rely on a continuous supply of oxygen for normal function.
Pain management, respiratory support, and monitoring for associated injuries.
It increases PaCO2 due to increased dead-space.
Absorption.
Emphysema and Chronic Bronchitis.
They are displaced to the opposite side and the superior and inferior vena cava collapse, occluding venous return to the heart.
Blunt trauma.
They can result in atelectasis and hypoventilation.
The amounts of oxy Hb and deoxy Hb present in the blood.
To avoid overlooking other pathologies associated with COPD.
Penetrating injury.
Due to the presence of many anastomoses.
In a very controlled way.
5 litres per minute.
60-100%.
Cigarette smoking.
Nasal cannula, face mask, non-rebreather mask, and mechanical ventilation.
Hypocapnia and respiratory alkalosis.
Emphysema and Chronic Bronchitis.
2 L/minute.
Yes, if there is a compensatory increase in haemoglobin level and cardiac output (CO).
It is low and moves poorly.
Pneumothorax, tension pneumothorax, haemorrhage, and shock.
Because once tension pneumothorax has been diagnosed, a state of cardiovascular collapse is imminent.
Above C-3 can lead to apnea, between C-5 and T-12 can cause varying degrees of dyspnea.
A 'loose' segment of chest wall with paradoxical movement.
It may be necessary for effective ventilation.
88 - 92%.
First two ribs.
Different.
Bag-valve mask.
To provide additional oxygen to maintain adequate tissue oxygenation.
It can result in a loss of contractility and arrhythmias.
Airflow limitation that is not reversible.
Same as that seen with the deoxyhemoglobin absorbance curve.
Chronic Bronchitis.
It draws air into the pleural space.
Management may include airway management, oxygen therapy, chest tube insertion, and surgical intervention in severe cases.
Diffusion defect.
28%.
950 nm.
An increased V/Q mismatch occurs when perfusion is increased relative to ventilation, leading to inadequate oxygenation of blood.
Secondary chronic bronchitis, with increased TLC and residual volume.
PDA, VSD, ASD, pulmonary edema.
Exclusively blunt trauma such as falls, motor vehicle accidents (MVA), assault, and crush type of injuries.
Respiratory alkalosis.
The total pressure exerted by a gaseous mixture is equal to the sum of all of the partial pressures of each individual component in the gas mixture.
Transportation to hospital for assessment to determine the need for a formal chest drain.
Coughing up blood, ranging from mild to severe.
Red light.
Around 0.8.
Benzodiazepines and opiates.
The saturation of oxyhemoglobin in the blood.
Introduction of blood between pleural layers has the same effect as air, leading to separation and atelectasis. Additionally, there is a hypovolaemic component due to blood loss.
Chronic Obstructive Pulmonary Disease.
Low PAO2 indicates a potential issue with oxygen intake or regulation.
Analgesia (IV).
Poor response to oxygen therapy.
When an embolus blocks or obstructs blood flowing through a pulmonary artery or one of its branches.
It falls somewhere between the oxyhemoglobin curve and deoxyhemoglobin curve.
Chronic Obstructive Pulmonary Disease.
More than 3 million.
A decreased V/Q mismatch can occur when ventilation is increased relative to perfusion, leading to excessive removal of carbon dioxide.
In some areas where the lungs may be better ventilated than perfused.
It has much greater affinity for haemoglobin than does O2 and displaces the O2 from the haemoglobin.
It decreases the V/Q ratio (resulting in decreased PAO2 and PaO2).
Anemia.
Yes, in cyanide poisoning, cells are unable to utilize oxygen despite having normal blood and tissue oxygen level.
The symptoms such as shortness of breath and chest pain result from the blockage of blood flow in the pulmonary arteries.
Shortness of breath, chest pain, and coughing up blood.
Mouth-to-mouth, mouth-to-nose, and mouth-to-mask.
It is the presence of blood in the pleural space, between the visceral and parietal pleura.
Atmospheric pressure and concentration are related to Dalton's Law by influencing the partial pressures of individual components in a gas mixture.
Endothelial damage.
Motor vehicle accidents (MVA), pedestrian vehicle accidents (PVA), and assault.
Leakage of K+ (mainly from the liver), which in severe cases can result in hyperkalaemia.
Pulmonary contusion.
It means that in some areas of the lungs, the alveoli and capillaries don't line up or there is dead space.
Shunt, where there is no ventilation.
By analyzing the ratio of red light and infrared light absorbed.
It is caused by blunt or penetrating trauma, and bleeding can be arterial or venous from various vessels.
It can indicate that there are more capillaries than alveoli, meaning areas that are better perfused by blood than ventilated.
Excessive mucous production in the bronchial tree, nearly always accompanied by chronic or recurrent cough.
It creates more of a problem.
They show signs and symptoms of both emphysema and chronic bronchitis.
Infection.
Complete lower airway obstruction or flooding of alveoli with fluid.
By causing secondary bronchoconstriction.
It contributes to the pathophysiology of PE.
Due to the heavy back muscles that prevent movement of the flail segments.
Over a large area.
Patients with stable vital signs but still at risk of deterioration, needing close monitoring and advanced care.
Not enough blood reaches the tissues.
Respiratory system trauma refers to physical injuries or damage to the respiratory system, including the airways, lungs, and chest wall.
Especially in the case of small emboli.
Shortness of breath, chest pain, rapid heart rate, and in severe cases, cyanosis.
It is the most common cause of Hypoxaemia and a component of most causes of respiratory failure.
Difficulty in breathing, ranging from mild to severe.
It indicates the presence of both oxyhemoglobin and deoxyhemoglobin.
They are affected to the point of destruction and dilation of their walls.
Raised intracranial pressure.
1,000,000,000 nanometers.
Decrease in lung surface area for diffusion, inflammation, fibrosis of the alveoli-capillary membrane, low alveolar oxygen, and extremely short capillary transit time.
The process of delivering O2 to the blood by diffusion from the alveoli.
Intubation and ventilation.
Carbon Monoxide (CO) poisoning.
It worsens the V/Q mismatch.
After 12 hours.
Chronic productive cough, frequent respiratory infections, diminished respiratory drive, hypoventilation, hypoxia, hypercapnia, and minimal dyspnea at rest.
It carries blood from the right side of the heart to the lungs.
Hypertrophy of the bronchial mucosal glands, an increase in the number and size of goblet cells, inflammation cell infiltration, and edema of the bronchial mucosa.
Total lung capacity (TLC) and diaphragm position.
Patients develop Cor Pulmonale.
Hypoxia.
Pleura, lung, aorta, subclavian vessels, bronchi, spleen, and liver.
Inhalation burns or anaphylactic reactions.
It is characterized by a worsening of the patient’s respiratory symptoms, beyond normal day to day variations, requiring a change in medication and/or management.
They are at high risk of sudden cardiac events.
A condition where blood from the right side of the heart enters the left side without participating in gas exchange.
It diverts blood flow to healthy areas, leading to hypoxaemia.
Emphysema leads to destruction of the alveolar walls, causing decreased ventilation and increased perfusion, resulting in a V/Q mismatch.
Emphysema, Chronic Bronchitis, Asthma.
94 - 98%.
Supplemental oxygen.
Myasthenia gravis.
COPD leads to damaged airways in the lungs, causing them to narrow, making ventilation more difficult.
To raise the PaO2 without worsening the acidosis.
It decreases, although the mechanism is not known.
Defective delivery of oxygen or utilization of oxygen in the body.
Acute exacerbation.
Hyperinflated alveoli.
No, they do not always coexist.
Due to excessive mucous production and poor secretion clearance.
It sucks in when the patient breathes in and pushes out when the patient breathes out.
Poor secretion clearance.
Blood clots that travel to the lungs from the legs or other parts of the body.
Because its symptoms can mimic other conditions and it may not show up on initial tests.
It does not measure the amount of hemoglobin, the amount of blood flow to tissues, and only detects O2Hb and Hb.
Local tissue oedema.
35-60%.
They stop functioning normally.
Nanometer (nm).
It occurs when the oxygen transport across the alveoli-capillary membrane is impaired.
The movement of air in and out of the alveoli.
Emphysema.
Chronic bronchitis, asthma, pulmonary edema, airway obstruction.
There is a decrease in carrying capacity, independent of PaO2.
Causes related to both V/Q mismatching and ventilatory failure.
Hypoxemia, shortness of breath, chest pain, trauma, and other conditions.
The potential for injury to deep-seated organs.
It shows a poor response to oxygen therapy.
How much red light and infrared light is absorbed.
By analyzing the ratio of absorbed red light and infrared light.
It leads to right ventricular failure and decreased cardiac output.
It may cause a decrease in tidal volume.
Cor pulmonale.
It increases the V/Q ratio (resulting in increased PAO2 but decreased PaO2).
It decreases cardiac output.
Anticoagulant medications, thrombolytic therapy, and in severe cases, surgical intervention.
By respiratory movement of the thoracic cavity.
Low SpO2 or cyanosis.
Severe atelectasis on the injured side, mediastinal shift, interruption of venous return to the heart resulting in decreased cardiac output and hypotension.
High-velocity GSWs (gunshot wounds).
More than 750 ml.
Environmental change, weather, inhalation of trigger substance.
Bronchospasm, mucus plugs, inflammation, and airway obstruction worsen ventilation, decreasing the V/Q ratio.
650 nm.
As failure of maintenance of normal arterial blood gas partial pressures due purely to a reduction in alveolar ventilation.
Ventilator.
Sputum production most days of the month for 3 months or more for at least 2 years.
The alveoli are ventilated but not perfused, leading to High V/Q Mismatch.
It is formed elsewhere, such as on the arm or leg (DVT), and then eventually manages to break free.
Reservoir bag inflated > 1/3 of its volume at all times.
Understand how increases and/or decreases in either will affect the V/Q ratio and the effect this will have on PaO2.
Underlying and associated structures.
24-50%.
Heavy smoking and forms of air pollution common to industrial environment.
Polycythaemia.
The clinical features such as shortness of breath, chest pain, and decreased oxygen levels reflect the underlying damage and dysfunction in the respiratory system.
21-40%.
Because of pulmonary contusion.
Especially through capillaries.
Tachycardia, weak peripheral pulses, cool and pale skin.
Usually approximately 0.8.
Chest decompression.
The greater the blood loss, the greater the atelectasis and the greater the degree of shock.
Emphysema, with polycythemia and cyanosis.
Characteristically thin wasted appearance.
Vascular obstruction by thrombus and chemical mediators from platelets.
It is the death of lung tissue due to a lack of blood supply caused by a pulmonary embolism.
Respiratory alkalosis.
Pink Puffer.
Simultaneous hypoxaemia and hypercapnia will have harmful physiological effects.
The presence of oxy Hb and deoxy Hb in the blood.
By slowing down ciliary and phagocytic activity, causing increased mucus accumulation and weakening defense mechanisms.
"Blue Bloater".
It acts as a narcotic and decreases LOC (level of consciousness).
Emphysema and secondary chronic bronchitis.
12-15 litres/minute.
It increases cerebral blood flow by dilating cerebral arteries.
15 L/minute.
A blockage in one of the pulmonary arteries in the lungs, usually caused by blood clots.
Heavy smokers.
Aspiration.
