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Airway and Respiratory

Dr. Anna Millizia, M.Ked (An), Sp. An


most important lifesaving skills:

Airway care
Rescue breathing

ABCs consist of:


Life Threats


maintain life, all humans must have

food, water, and oxygen.
Lack of oxygen, even for a few minutes, can
result in irreversible damage and death.


main purpose of the respiratory

system is to work with the circulatory
system to provide oxygen and remove
carbon dioxide via the red blood cells.

Respiratory System


all cells will die if deprived of

oxygen. Brain and heart are the most

Time is Critical!

At the back of the throat are two passages:

The esophagus
The trachea
The epiglottis helps prevent food or water
from entering the airway.
The airway divides into the bronchi.
The lungs are located on either side of the
heart. The right lung has 3 lobes, the left has
2 and the heart sits slightly more towards the
left side.

Anatomy of the
Respiratory System


parts of the respiratory system:

The smaller airways that branch from the
bronchi are called bronchioles.
At the end of the bronchioles are tiny air sacs
called alveoli.
The exchange of oxygen and carbon dioxide
occurs in the alveoli.

Anatomy of the
Respiratory System

Anatomy of the
Respiratory System

Anatomy of the
Respiratory System


lungs consist of soft, spongy tissue with no

Movement of air into the lungs depends on movement
of the rib cage and the diaphragm muscles.
When the diaphragm contracts during inhalation, it
flattens and moves downward, increasing the size of
the chest cavity.
Air moves in and out of the lungs because of pressure
changes, moving from high to low pressure to equalize.
On exhalation, the diaphragm relaxes and once again
becomes dome shaped, decreasing the size of the chest

Anatomy of the
Respiratory System

Ask callers to:

Evaluate the victims
responsiveness. If
theres a response,
assume that the
patient is conscious
and has an open
If there is no
response, advise
callers to gently
shake the patients
shoulder and repeat

Check for Responsiveness


healthy individuals, the airway

automatically stays open.


injured or seriously ill person is not

able to protect the airway and it may
become blocked.
You must take steps to have callers check the
airway and correct any problems.

A Is for Airway


an unconscious patient lying on his or

her back, the passage of air through both
nose and mouth may be blocked by the
The tongue is attached to the lower jaw.
A partially blocked airway often produces a
snoring sound.
The head tilt chin lift will fix the problem.

Correct the Blocked Airway


tiltchin lift
Place the patient on his
or her back.
Place one hand on the
patients forehead and
apply firm pressure
Place the tips of your
fingers under the bony
part of the lower jaw.
Lift the chin forward and
tilt the head back.

Correct the Blocked Airway


blocks include:

Secretions such as vomit, mucus, or blood

Foreign objects such as candy, food, or dirt
Dentures or false teeth

there is anything in the patients

mouth, remove it.
Finger sweeps can be done quickly and require
no special equipment.

Correct the Blocked Airway


an unconscious patient is breathing and has

not suffered trauma, place the patient in the
recovery position.
Helps keep the patients airway open
Allows secretions to drain out of the mouth
Uses gravity to help keep the patients tongue
and lower jaw from blocking the airway

Recovery Position


the look, listen, and feel technique.

Look for the rise and fall of the patients chest.

Listen for the sounds of air passing into and
out of the patients nose or mouth.
Feel the air moving on the side of your face.

Adults have a normal breathing rate of 12

to 20 breaths per minute, children 15 to
30 and infants 25 to 50.

B is for Breathing


of respiratory arrest

Heart attacks
Mechanical blockage or obstruction caused by the
Vomitus, particularly in a patient weakened by a
condition such as a stroke
Foreign objects
Illness or disease
Drug overdose
Severe loss of blood
Electrocution by electrical current or lightning

No Breathing.. Start CPR

30 compressions in the center of the chest,

2 inches deep. Pushing hard and fast, 100
times per minute.
As you perform breathing, keep the patients
airway open. (head-tilt)
Pinch the nose, take a deep breath, and blow
slowly into the mouth for 1 second.
Remove your mouth and let the lungs deflate.
Breathe for the patient a second time.
Alternate 30:2 compressions and breaths, until the
patient responds or experienced help takes over.



most common airway obstruction is

the tongue.
If the tongue is blocking the airway, the head
tiltchin lift maneuver will clear the patch for
air movement.


is the most common foreign object

that causes an airway obstruction.
If a foreign body is lodged in the air passage,
you must use other techniques to remove it.

Causes of Airway Obstruction

If conscious:Ask the patient, Are you

If the patient can reply, the airway is not
completely blocked.
If the patient cannot speak or cough, the airway is
completely blocked.


airway obstruction

The patient coughs and gags.

The patient may be able to speak, but with
difficulty. Encourage the patient to cough.

Are You Choking?


airway obstruction

The patient is unable to breathe in or out and

speech is impossible.
Other symptoms may include:
Poor air exchange
Increased breathing difficulty
A silent cough
Loss of consciousness in 3 to 4 minutes
Treatment involves abdominal thrusts.

Are You Choking?


obstruction in an adult or child

If the patient is conscious, stand behind him

or her and perform abdominal thrusts.
Perform CPR on a patient who has become

Are You Choking?


obstruction in an infant

If the infant has an audible cry, the airway is

not completely obstructed.
Use a combination of 5 back slaps and 5 chest
thrusts, if the infant is awake but not
breathing from airway obstruction.
If the infant becomes unresponsive:
Begin CPR.
Continue CPR until EMS personnel arrive.

Are You Choking?


every patient for the presence of a stoma.

If you locate a stoma, keep the patients neck
Examine the stoma and clean away any mucus
in it.
Place your mouth directly over the stoma and
use the same procedures as in mouth-to-mouth
If the patients chest does not rise, seal the
mouth and nose with one hand and then breathe
through the stoma.

Breathing for Patients With



when air is forced into the

stomach instead of the lungs



the chance that the patient will


slowly into the patients mouth,

just enough to make the chest rise.


sure airway is properly tilted open.

Gastric Distention

There are a variety of problems that

can cause Difficulty in Breathing
(DIB) or Shortness of Breath (SOB).
The rest of the presentation will
cover some of those conditions.

Respiratory Emergencies

Noisy respirations, wheezing, or gurgling (rales or

click on this link to listen to abnormal lung sounds

Rapid or gasping respirations

Pale or blue skin
Increased work of breathing
Talking in 1 or 2 word sentences
The most critical sign is respiratory arrest, which is
characterized by:

Lack of chest movements

Lack of breath sounds
Lack of air against the side of your face

Signs of Inadequate Breathing


Upper or lower airway infection

Acute pulmonary edema (Fluid in lungs)
Chronic obstructive pulmonary disease (COPD)
Hay fever
Hyperventilation syndrome
Environmental/industrial exposure
Carbon monoxide poisoning
Infectious diseases




Anaphylaxis (Severe Allergic Reaction)

Spontaneous pneumothorax (Collapsed Lung)
Pleural effusion (Fluid around the Lung)
Prolonged seizures
Obstruction of the airway (Choking)
Pulmonary embolism (clot in Lung area)



inflammation of bronchioles. Patients

will have a productive cough and wheezing.
Common Cold viral infection with swollen
mucous membranes and excess fluid production
from sinuses and nose.
TB a respiratory disease that can lay dormant
in the lungs for years. Is spread by respiratory
Pneumonia viral or bacterial infection that can
damage lung tissue. Characterized by productive
cough, fever and congestion.
Diphtheria A highly contagious disease that
causes a layer of debris to form in the upper
airway and can causes obstruction. This is a rare

Airway Infections

Epiglottitis Bacterial infection that affects mostly school aged

children. Causes swelling of the flap above the larynx. Patients
will have Stridor (a harsh, high pitched sound) as the air moves
past the swelling. They will also have a fever, sore throat and
Croup Viral Infection, usually seen in children under 3years old.
Causes inflammation of the airway and a seal bark type of
RSV Highly contagious infection that is spread through airborne
droplets. Affect young children and can lead to more serious lund
or heart problems.
Pertussis (Whooping Cough) Highly contagious bacterial
infection that mostly effects children under 6. Patient will have a
fever and coughing episodes where they cant catch their breath.
SARS Potentially life-threatening viral infection that starts with
flu-like symptoms and can progress to death. Spread from
person-to-person contact.

Airway Infections


process of dilation and disruption of airways

and alveoli


by chronic bronchial obstruction

leading cause of death


smoke can create chronic bronchitis.


is another type of COPD.

Loss of elastic material around air spaces

Causes include inflamed airways, smoking.

patients with COPD have elements of both

chronic bronchitis and emphysema.

Chronic Obstructive Pulmonary

Disease (COPD)

Result of allergic reaction to inhaled, ingested, or injected

In some cases, allergen cannot be identified.
Asthma is acute spasm of smaller air passages
Excessive mucus production
Swelling of mucous lining of respiratory passages.
Hay fever causes cold-like symptoms.
Allergens include pollen, dust mites, pet dander.
Anaphylactic reaction can produce severe airway swelling.
Total obstruction is possible.
Reaction occurs within 30 minutes of exposure

Asthma, Hay Fever, and



deep breathing to the point that arterial carbon

dioxide falls below normal
May be indicator of major illness
High blood sugar, overdose of aspirin, respiratory
infection, etc
Acidosis: buildup of excess acid in blood or body
Alkalosis: buildup of excess base in body fluids
Alkalosis can cause symptoms of panic attack,


Genetic disorder that affects lungs

and digestive system
Disrupts balance of salt and water
resulting in very thick mucus
Disposed to repeated lung
infections and malabsorption of
nutrients in intestines

Cystic Fibrosis


problem that causes fluid to back

up in the lungs
Risk factors include hypertension and a history
of coronary artery disease and/or atrial
In most cases, patients have a history of
congestive heart failure.


patient assume a comfortable

position, usually sitting up and leaning
Loosen any tight clothing.
Follow their doctors orders for any
medication administration.
If there is oxygen on scene, it is helpful in
cases of DIB.