Process of Life
Air goes in and out, blood goes round and round, and any deviation is considered a bad thing. Oxygen is good, blue is bad. ABC is more than a group of random letters. Airway first, breathing second, circulation third. These are just a few of the clever sayings you will come across while working in the various health care fields. However, these sayings are more than just clever. They are two things: 1) rules 2) description of a group of processes. Airway management, ventilation, respiration, and oxygenation are the processes which inspired such sayings. The body relies on each of these processes to maintain homeostasis, but if one process should fail then trouble ensues and if left uncorrected, death. Being able to quickly assess, treat, and correct a failure in these processes is key to saving a patient and minimizing tissue damage.
airway management and Ventilation
Bledsoe (2009, pg. 533, ¶ 1) states that “airway management and ventilation are the first and most critical steps in the initial assessment of every patient.” Since ventilation is described as the “mechanical process that moves air into and out of the longs” (Bledsoe, 2009, pg. 541), it is safe to say that airway management and ventilation go hand-in-hand. Without a properly maintained airway, it is impossible for the body to ventilate.
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During a time of homeostasis, the body is able to properly maintain the upper and lower portions of the airway with little to no effort. However, there are times when this is not the case and swift and accurate intervention is needed. Barker (2008, ¶ 1) says “basic airway management is most often needed because of inadequate ventilation, which can result from impaired respiratory effort or airway obstruction. Basic airway interventions may also be needed to manage the patient with inadequate oxygenation and during cardiopulmonary resuscitation. Bag-mask ventilation is the cornerstone of basic airway management.” The use of a BVM can be aided by airway adjuncts such as NPA’s or OPA’s that assist in the maintaining of a patient airway.
In short, for the body to be ventilated, air must be able to move from outside the body and into the lungs. Ventilation cannot occur if an airway is not patent. Thus, the further process of respiration and oxygenation cannot occur.
Respiration and Oxygenation
When looking at respiration and oxygenation, it is easy to quickly assume that both terms are describing the same thing. However, this is not the case and understanding the differences is key to understanding the final piece of the puzzle. If respiration cannot occur, neither can oxygenation.
Respiration is best defined as “the exchange of gases between a living organism and its environment”(Bledsoe 2009, pg. 541, ¶ 2).
Respiration occurs in two environments when relating to the human body. The first is between an external air source and the lungs. The second takes place on a cellular level in the peripheral capillaries. Similar to respiration, oxygenation takes place in two environments as well. The first is the saturation of the blood with oxygen from the lungs. The second is when oxygen is delivered to all the parts of the body via the blood. Tools such as capnography and pulse oximetry can help determine if oxygenation and respiration are taking place. However, it is best to treat your patient and not your machines.
The Whole Picture
Airway management, ventilation, respiration, and oxygenation are all part of a smooth running machine. The idea, or process, as a whole is a simple one. However, when broken down and examined, it is clear to see that things are much more complex. Although complex, each process is reliant on another process in order to maintain homeostasis.
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