August 11, 2014
This Monday, let’s look how air affects our lives.
This un-narrated slide show will help provide significant insight into what we really do with the air we breathe.
On important concept to consider when working with the respiratory system is the difference between Ventilation and Respiration.
Ventilation is simply the air going in and out of the body. The lungs are not muscles and are simply passive containers. As we breathe the diaphragm contracts and shifts inferiorly. In addition, our intercostal muscles contract pulling our rib cage outward. These two actions create a negative airspace that is filled with surrounding air through our nose or mouth. As these muscles relax the chest cavity becomes smaller, creating more pressure on the space and forces air outward. As patrollers we can do a lot to affect ventilation. By stabilizing the chest structure, we can help the patient breathe with greater efficiency. By utilizing a pocket mask or BVM we can force air into the lungs and allow the patient’s own body weight to expire the new air.
But we can have very little effect on Respiration. Respiration is the exchange of the Oxygen and Carbon Dioxide gas at the cellular level. If there are underlying problems, such as cardiac arrest, all of the air that put in and out of the patient will not move around to the cells that need resupply.
There may be other underlying reasons that the respiration is not happening effectively. While many of these reasons are beyond our scope, I’d like you to consider the cardiac rate as something that we can use to determine how well oxygen is moving around the body.
If I were to hold you by the neck and squeeze, besides kicking me in a very private spot, your first reaction would be to run. The heart rate will do just that, initially to try to push past the problem. But if I were to continue to hold you’d eventually slow down because you didn’t have enough energy. The heart will again do the same.
If the heart is beating to slow to properly move the oxygenated blood around, we need to find a way to speed it up. EMS is our friend in this instance and should be immediately notified.
If the heart rate is too fast, blood cannot return to the heart fast enough and the heart starts to race out of control without pushing enough blood. Again EMS is indicated.
As a general rule, fast heart rates are generally more stable and can be controlled by having the patient relax while waiting for EMS. Our bodies can handle fast heart rates much more easily than slow . . . or else the Y would’ve been out of business a long time ago.