Chapter 10: Airway management, Artificial Ventilation, and Oxygenation – Flashcards
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An elderly male who is short of breath is on home oxygen. He is wearing a nasal cannula connected to an oxygen tank with the flow regulator set to 3 liters per minute. As a knowledgeable EMT, you should recognize that the patient is getting approximately what percentage of oxygen with each breath?
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32%
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Which one of the following statements about ventilation of a non breathing patient through a stoma is true? A nasal airway should be inserted into the stoma prior to any attempt at ventilating the patient. A head-tilt, chin-lift or jaw-thrust maneuver is still needed to open the airway. The EMT should ventilate through the stoma with a child-sized face mask attached to a bag-valve mask. Mouth-to-stoma ventilation is an easy and safe procedure to perform on a non breathing patient.
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The EMT should ventilate through the stoma with a child-sized face mask attached to a bag-valve mask.
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You arrive at a residence for a male patient who is unresponsive. As you enter the room, you observe an obese male lying on a recliner. His eyes are closed, and he has gurgling respiration's. While your partner quickly performs a primary assessment, you should immediately prepare to:
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Suction the airway
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Assessment findings for an alert and oriented patient complaining of shortness of breath reveal an open airway and strong radial pulse, accompanied by skin that is cool and diaphoretic. The depth of respiration's is adequate, and breath sounds include wheezing throughout the lungs. Vital signs are a pulse of 124, respiratory rate of 24, blood pressure of 146/82 mmHg, and SpO2 93%. The patient has a history of asthma for which he takes medications. How should you administer oxygen to this patient?
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Nonrebreather mask
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Your paramedic partner has applied continuous positive airway pressure (CPAP) to a patient in respiratory distress from congestive hear failure (CHF). As an EMT, you realize that this should benefit the patient by:
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forcing fluid in the lungs back into the bloodstream
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Which one of the following statements indicates the EMT has an accurate understanding of the bronchioles? "They are large airways located before the carina and are made of cartilage." "They are small passages located in the lower airway that have smooth muscle surrounding them." "They are large structures that pass oxygen from the lungs directly into the bloodstream." "They are small air sacs located just before the alveoli."
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"They are small passages located in the lower airway that have smooth muscle surrounding them."
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You must suction a male patient who has a decreased ability to swallow secondary to a previous stroke. He also has a history of smoking and lung cancer. Which one of the following represents the most appropriate personal protective equipment that you should use with this patient? Gloves Gloves, gown, HEPA respirator mask Gloves, mask with face shield Gloves, and goggles
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gloves, mask with face shield
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A patient with a stoma and tracheostomy tube is responsive to painful stimuli and breathing shallowly at 6 times per minute. He has cyanosis of the fingertips and a weak, rapid radial pulse. Which one of the following is best in providing respiratory care to this patient? Use a continuous positive pressure device over the stoma. Attach the bag-valve device directly to the tracheostomy tube.
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Attach the bag-valve device directly to the tracheostomy tube
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The EMT is correctly performing the jaw-thrust maneuver when she: Opens the airway by slightly extending the head and thrusting the jaw upward. Places one hand on the forehead and lifts the jaw upward with her other hand. Places her hands on the side of the patient's head and lifts the jaw upward. Maintains the head in a neutral position and slightly tilts the head backward
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Places her hands on the side of the patient's head and lifts the jaw upward.
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Which one of the following actions indicates that the EMT is correctly using a nonrebreather face mask on an adult patient? He instructs the patient to take deeper breaths when the mask is on . He ensures that the reservoir fully collapses with each breath. He fully inflates the reservoir prior to placing it on the patient. He sets the oxygen flow rate between 6 and 16 liters per minute.
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He fully inflates the reservoir prior to placing it on the patient.
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The EMT has just placed an oropharyngeal airway in a patient. By doing so, which one of the following has the EMT accomplished? Protected the airway from vomit or other secretions Minimized the risk of vomiting by closing off the esophagus. Secured the tongue away from the back of the airway. Obtained a patent airway by preventing closure of the mouth.
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Secured the tongue away from the back of the airway.
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Which one of the following statements about an automatic transport ventilator (ATV) is true? It eliminates the need for a head-tilt, chin-lift or jaw-thrust maneuver The EMT has greater ease in determining an increase or decrease in lung compliance. When it is in use, there is no need for a face-to-mask seal It can help minimize gastric distention associated with positive pressure ventilation
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It can help minimize gastric distention associated with positive pressure ventilation.
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You are observing an EMT insert an oropharyngeal airway into the airway of a 36-year-old male who has overdosed on a street drug. Which one of the following observations indicates correct technique? The EMT uses a tongue depressor to press the back of the tongue downward, and then inserts the oral airway upside-down The airway is inserted in its normal anatomic position until the flange of the airway is 1 cm above the lips. The oral airway is introduced sideways into the mouth, and then rotated 180 degrees once it has reached the base of the tongue. The airway is inserted into the mouth upside-down and is then turned 180 degrees once it contacts the soft palate.
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The airway is inserted into the mouth upside-down and is then turned 180 degrees once it contacts the soft palate.
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You are watching an EMT prepare the ambulance for the upcoming shift. In regards to oxygen cylinders and equipment, which one of the following requires immediate intervention? He ensures that the temperature in the oxygen storage room is under 100 degrees He makes certain that all valves on the empty oxygen tanks are closed He cleans a dirty oxygen tank with a petroleum-based agent. He lays tanks on the floor when removed from the ambulance.
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He cleans a dirty oxygen tank with a petroleum-based agent.
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A patient complaining of shortness of breath and a history of asthma has the following vital signs: pulse 96, respiration's 20, blood pressure 132/86, and SpO2 92% on room air. Mild wheezing is noted bilaterally and the patient states that she has run out of her rescue inhaler (albuterol). Regarding the patient's respiratory status, you would administer: 4 lpm O2 through a nasal cannula 12 lpm O2 through a nonrebreather 2 lpm O2 through a nasal cannula 15 lpm O2 through a nonrebreather
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2 lpm O2 through a nasal cannula
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When inserting a nasopharyngeal airway, the EMT should remember that the: nasal mucosa may bleed even with proper insertion head-tilt, chin-lift or jaw-thrust is not needed after insertion patient cannot be responsive nor have a gag reflex oil-based lubricant is needed for smooth insertion
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nasal mucosa may bleed even with proper insertion
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Assessment findings on an elderly patient with congestive heart failure indicate that her failing heart is causing fluid to collect and fill her alveoli. Based on this pathophysiology, for which pulmonary complication should the EMT treat the patient? Decreased gas exchange Decreased blood pressure Swelling of the tongue collapse of the bronchi
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Decreased gas exchange
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Which of the following is true regarding the form or function of the alveoli? The alveoli are covered with small arteries that allow gas exchange The alveoli permit gas exchange between the lungs and bloodstream. The alveoli are air passages that permit ventilation of the lung the alveoli are thin walled and covered by smooth muscle
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The alveoli permit gas exchange between the lungs and bloodstream
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When a person's diaphragm contracts and intercostal muscles pull the ribs upward, which one of the following will occur? oxygen will leave the body. carbon dioxide will be exhaled air will flow into the lungs pressure inside the chest will increase
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Air will flow into the lungs
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The difference between respiration and ventilation is best described as:
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Respiration describes the exchange of O2 and CO2 while ventilation describes the movement of air that carries them.
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Which one of the following best describes oxygen? An odorless cloudy gas when pressurized a highly flammable substance a moist gas that supports combustion a gas classified as a drug
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a gas classified as a drug
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A young male patient has been stabbed in the right lateral chest. Regarding the respiratory system, which of the following represents the greatest danger to his well-being? Loss of oxygen from the lungs through the stab wound collection of air between the pleural and visceral membranes fracture of the rib and predisposition to a pulmonary infection loss of serous fluid from the membranes of the chest
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Collection of air between the pleural and visceral membranes
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Which one of the following patients should the EMT recognize as being mildly hypoxic? 36-year-old female with asthma, breathing 22 times per minute with cyanosis to her fingertips 44-year-old male breathing 22 times per minute who is confused and has an SpO2 of 97% 24-year-old female breathing 8 times per minute with cyanosis to her lips 18-year-old male who is restless and breathing shallowly at 16 times per minute with no cyanosis
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18-year-old male who is restless and breathing shallowly at 16 times per minute with no cyanosis
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Which of the following would cause the greatest decrease in oxygen delivery to the cells? Decreased amount of circulating hemoglobin diastolic blood pressure >100 mmHg Heart rate above 120 bpm Temperature above 103 degrees
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Decreased amount of circulating hemoglobin
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The EMT would recognize that administering continuous positive airway pressure (CPAP) at too high of a pressure can cause: hypertension lung collapse oral cavity pressure trauma pulmonary edema
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Lung collapse
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You must suction frothy secretions from the mouth and pharynx of a 31-year-old male patient whose respiration rate is 4 breaths per minute. Which one of the following interventions is most appropriate given the patient's condition? Suction for no more than 15 seconds at a time followed by 2 minutes of positive pressure ventilation. Place the patient into a side-lying position and alternate 30 seconds of suctioning and ventilation. forego suctioning and continue to provide positive pressure ventilation use a soft-tip catheter and suction for nor more than 30 seconds before providing additional oxygen with a nonrebreather face mask.
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Suction for no more than 15 seconds at a time followed by 2 minutes of positive pressure ventilation.
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While the EMT is inserting an oropharyngeal airway, the patient gags. The EMT should:
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Remove the airway and maintain the head-tilt, chin-lift
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When using a therapy regulator, which one of the following can be readily observed? Concentration of oxygen received by the patient temperature of oxygen in the cylinder flow rate of oxygen leaving the oxygen cylinder liters of oxygen remaining in the oxygen cylinder
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Flow rate of oxygen leaving the oxygen cylinder
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Hypoxia occurs when which of the following occurs? The respiratory rate falls below 12 breaths per minute Inadequate amounts of O2 are available to the cells Carbon dioxide is excreted too rapidly from the lungs Carbon dioxide accumulates within the body.
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Inadequate amounts of O2 are available to the cells
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You have been called to a long-term nursing care facility for a 77-year-old female patient with Parkinson's disease. According to the nursing staff, she is more confused than normal and is to be transported to the emergency department for evaluation. Since the patient neither understands nor can answer any of your questions, which one of the following signs provides the best evidence that her breathing is adequate? Strong radial pulse Respiratory rate of 18 Pulse oximeter reading at 98% Clear breath sounds
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Pulse oximeter reading at 98%
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A patient with a heavy smoking history and chronic obstructive pulmonary disease (emphysema) presents in marked respiratory distress with cyanosis noted to her fingertips. When administering oxygen to this patient, the EMT would remember that:
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High-concentration oxygen must be provided if the patient's condition warrants.
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Your medical director is holding an in-service focusing on the prehospital management of adult patients with respiratory complaints. He asks the group to explain how they can determine if the patient is breathing adequately. Which one of the following responses is most appropriate? "Checking the patient's breath sounds with a stethoscope is the best way to determine if a patient's breathing is adequate." "A patient is breathing adequately if the depth of breathing is shallow, but the rate is increases above normal." "For an adult patient to be breathing adequately, the rate should be withing 8 to 24 breaths per minute with a full chest rise with each breath." "The EMT can assume breathing is adequate if the patient has an open airway and a normal respiratory rate."
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"The EMT can assume breathing is adequate if the patient has an open airway and a normal respiratory rate."
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You are checking the D oxygen tank in the ambulance and note that the reading on the pressure regulator reads 1,000 psi. You should recognize that the tank is:
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Half full
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Which one of the following actions should you perform when attaching a therapy regulator to a new oxygen tank? Lubricate the stem of the cylinder with oil prior to attaching the regulator. Open the cylinder valve for 1 second prior to attaching the regulator. Tighten the regulator to the oxygen cylinder with an oxygen wrench. Stand the tank upright on the floor for 2 minutes prior to attaching the regulator.
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Open the cylinder valve for 1 second prior to attaching the regulator
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You are assessing an unresponsive patient who overdosed on a narcotic pain medication. Given the situation, what is the greatest concern regarding potential airway occlusion?
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relaxation of the tongue
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In a healthy person, the primary stimulus to breathe is:
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Carbon dioxide
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The EMT exhibits an accurate understanding of breathing when he states: "Respiration is best described as the process of moving air into and out of the body." "In between breaths, the epiglottis protectively closes over the trachea." "When a person inhales, carbon dioxide is drawn into the lungs, and when he exhales, oxygen leaves the body." "Inhalation requires energy, while exhalation for most patients is a passive process."
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Inhalation requires energy, while exhalation for most patients is a passive process.
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The EMT is appropriately sizing the nasal airway when she measures the:
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Distance from the nose to the earlobe
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A patient who inhaled superheated steam in an industrial fire is most likely to exhibit which one of the following airway noises? Snoring gurgling wheezing stridor
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Stridor
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What statement made by another crew member would cause you to disregard the use of continuous positive pressure airway pressure (CPAP) for a patient? "His respirations are agonal and slow." "His SpO2 has fallen from 92% to 88%." "He had bleeding stomach ulcers two years ago." "His blood pressure is 186/108 mmHg."
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"His respirations are agonal and slow."
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You are assessing a young male patient who is responsive to painful stimuli and breathing agonally after being ejected from an automobile at a high rate of speed. His pulse is weak and thready, and his skin is cool and diaphoretic. When addressing his airway and breathing, the EMT must immediately: Immobilize him to a long spine board, and then start positive pressure ventilation. perform the jaw-thrust and begin artificial ventilations with the bag-valve mask. administer oxygen at 15 lpm with a nonrebreather face mask. open the airway using the head-tilt, chin-lift and begin ventilations with the bag-valve mask.
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Perform the jaw-thrust and begin artificial ventilations with the bag-valve mask.
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A paramedic has asked you to place the patient on a nonrebreather mask at 15 liters per minute. To administer oxygen at this flow rate, you should: slowly decrease the tank pressure valve until 15 psi is achieved attach a high-pressure regulator to the oxygen cylinder. adjust the tank pressure to 15 pounds per square inch select 15 on the oxygen therapy regulator.
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select 15 on the oxygen therapy regulator
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The EMT should use the jaw-thrust maneuver to open the airway for the patient with which one of the following? Unresponsive after falling from a porch Overdose with snoring respirations Stroke with gurgling respirations Cardiac arrest in bed
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Unresponsive after falling from a porch
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Which one of the following is obstructing the airway when snoring is heard? Bronchospasm The tongue Fluid in the upper airway Swelling of the larynx
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The tongue
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You are starting to ventilate a patient with a laryngectomy and stoma. As you provide the first few ventilations, you note that the air passes easily into the patient, but does not cause the chest to rise. Your next action should be to:
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Seal the patient's mouth and nose
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Typically, the highest continuous positive airway pressure (CPAP) pressure for for therapy is:
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10 cmH2O
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You are having a difficult time getting air from the bag-valve mask to pass into the patient's lungs. Your first action should be to:
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perform the head-tilt, chin-lift again.
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The structure that lies between the trachea and bronchi is:
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Carina
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Which of the following statements, made by the EMT, reflects correct knowledge regarding the use of oxygen in patient care? "Oxygen administration should be used in such a way that a patient's SpO2 reaches 97% to 100%." "Overoxygenating a patient is not an issue for EMS, given the short amount of time we have patient contact." "Aside from chest pain, stroke, and trauma, oxygen is not longer used in emergency care." "Oxygen administration is no longer considered standard therapy for EMS."
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"Overoxygenating a patient is not an issue for EMS, given the short amount of time we have patient contact."
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Despite coaching and explaining the benefits of a nonrebreather face mask, a moderately short of breath and hypoxic patient with lung cancer states that she cannot tolerate the mask over her face. The more that she panics, the worse the shortness of breath becomes. Your best course of action would is to:
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disconnect the nonrebreather and replace it with a nasal cannula
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What condition would the EMT associate with a hypoxic respiratory drive?
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COPD
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A young child with multiple physical and developmental abnormalities has a severe nose bleed. You must suction his nasopharynx to decrease the amount of blood he is swallowing. Which of the following would be included in this care? Irrigate the nostrils with water to thin and loosen the blood prior to suctioning with a rigid catheter. Insert a soft catheter into the nose the same length as the distance from the patient's nose to the tip of his ear. Place the patient on his side and gently insert a rigid-tip catheter 1 inch into each nostril starting with the right. Insert a soft catheter through the nose past the base of the tongue
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Insert a soft catheter into the nose the same length as the distance from the patient's nose to the tip of his ear.
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Which one of the following statements shows that the EMT knows how to correctly position the BVM on the patient's face? "The wide portion of the mask is placed at the top of the nose and the narrow part below the lower lip." "I place the narrow part of the mask over the bridge of the nose, and the bottom part in the cleft above the chin." "The mask is properly position when the top portion lies over the bridge of the nose and the lower portion below the chin." "If two rescuers are using the BVM, the mask only needs to be place over the mouth and the nose pinched closed."
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"I place the narrow part of the mask over the bridge of the nose, and the bottom part in the cleft above the chin."
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A listless and lethargic 84-year-old male responds to physical stimuli with garbled speech. His respirations show poor effort and are rapid and labored with a room air SpO2 is 84%. Additionally, you cannot appreciate breath sounds in his right lung. The best form of oxygen therapy for this patient would be:
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Positive pressure ventilation
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The EMT shows that she understands how to use an oropharyngeal airway when she states: "I must watch the patient for vomiting or spasm of the vocal cords even with proper insertion." "Once it has been placed, the head-tilt, chin-lift is no longer needed." "If it is too small, it could push the epiglottis over the opening of the trachea." "It protects the patient from aspirating vomit or other secretions."
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"I must watch the patient for vomiting or spasm of the vocal cords even with proper insertion."
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You have opened the airway using a head-tilt, chin-lift and are ready to ventilate an apneic patient with a pocket mask. The first ventilation you attempt is unsuccessful. You should immediately:
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Reposition the head
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What body system or structure is responsible for the control and regulation of a person's breathing?
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brain
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In a healthy patient, for air to be exhaled from the lungs, what must occur?
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The diaphragm must relax
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A patient with chest discomfort has the following vital signs: pulse 88, respirations 14, blood pressure 154/84, and SpO2 97% on room air. In this situation, the EMT would address oxygen therapy by administering: Nasal cannula at 4 lpm no oxygen blow-by oxygen at 5 lpm nonrebreather at 15 lpm
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no oxygen
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When administering continuous positive airway pressure (CPAP) to a patient, you would recognize that the patient is benefiting from the treatment when the: patient can resume control of his airway heart rate increases from baseline by 10 percent blood pressure drops below 11 mmHg systolically patient states he is breathing easier
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patient states he is breathing easier
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When administering continuous positive airway pressure (CPAP) to a patient in respiratory distress, what statement made by the patient would be most concerning? "I feel nauseated." "The mask is too tight." "My nose hurts from the mask." "My mouth is getting dry."
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"I feel nauseated."
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You must immobilize a 6-year-old who was involved in a motor vehicle accident. Regarding the airway, why should you consider placing padding under his shoulders and back?
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The child's head is larger in proportion to his body
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Which one of the following patients should the EMT recognize as having an actual or potential occlusion of the upper airway? 3-year-old male with a fever and swelling of the larynx 45-year-old female with spasm of the bronchioles 78-year-old female with a large mucous plug in her bronchi 61-year-old male with a piece of fruit stuck in his trachea
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3-year-old male with a fever and swelling of the larynx
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What is the preferred method of providing high-concentration oxygen in the prehospital setting?
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nonrebreather face mask
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Which one of the following best describes the purpose of a Venturi mask? It provides a seal over the larynx, preventing aspiration during positive pressure ventilation Precise concentrations of oxygen are able to be delivered. It allows a 100% concentration of oxygen to be delivered. The device is used to deliver positive pressure ventilation
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Precise concentrations of oxygen are able to be delivered
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When administering oxygen to a hypoxic patient, what signs would seemingly indicate that the patient is improving? The respirations slow from 24 to 22 per minute The heart rate drops from 120 to 80 bpm The blood pressure increases from 136/78 to 150/86 mmHg The patient becomes more restful and wants to sleep
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The heart rate drops from 120 to 80 bpm
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When using a nonrebreather face mask, the EMT recognizes which one of the following? Oxygen is delivered into the lungs even when the patient is not inhaling. The air exhaled by the patient will be recycled with oxygen. The mask is comfortable and well tolerated by all patients when properly applied. Approximately 90% of the patient's tidal volume will be oxygen.
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Approximately 90% of the patient's tidal volume will be oxygen.
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You are assessing a patient with altered mental status. Which assessment finding contraindicates the use of the nonrebreather face mask? Respiratory rate of 18, with poor tidal volume. Respiratory rate of of 24 breaths per minute clear and equal breath sounds confusion
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Respiratory rate of 18, with poor tidal volume.
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Which one of the following statements about the bag-valve mask (BVM) is true? The oxygen reservoir should deflate by one-third every time a breath is given A 15/22 mm adapter allows the BVM to be attached to advanced airways such as the endotracheal tube. The nonrebreather valve allows the patient to rebreathe air that he has exhaled Oxygen must be attached so that the squeezable bag will reinflate.
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A 15/22 adapter allows the BVM to be attached to advanced airways such as the endotracheal tube.
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You have arrived on the scene of an assault in which several people have been injured. You are directed to assist another crew with a patient who has been shot once. As you approach, you are told that the patient is breathing erratically and ineffectively. You observe the patient being ventilated with a bag-valve mask while another EMT maintains her airway with the jaw-thrust maneuver. Based on your observation, where might you expect that this patient was shot? Pelvis Head Leg Lower abdomen
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Lower abdomen
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You are transferring an unresponsive patient from her house to the ambulance on the stretcher. An oral airway has been placed and ventilations with the bag-valve mask are being administered. Suddenly, the patient regains consciousness and starts to gag. Your immediate action should be to:
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remove the oral airway
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When monitoring a patient receiving oxygen through a nasal cannula, which one of the following observations warrants immediate intervention? Prongs in the nostrils curving posteriorly into the nose Tubing positioned over the ears and under the chin Oxygen flow rate of 15 liters per minute Breathing normally with the nasal cannula in place
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Oxygen flow rate of 15 liters per minute
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You arrive at a residence to assist another crew with a patient in cardiac arrest. As you enter the room, a brand new EMT informs you that he is having difficulty maintaining the mask seal to the patient's face while ventilating with the BVM. Which one of the following responses shows that you understand and can help with the problem? "Let me maintain the face-to-mask seal while you squeeze the bag." "Why don't you try using a larger adult mask and flex the head forward?" "I will administer some cricoid pressure. That should help." "I will check breath sounds to see if air is reaching the lungs."
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"Let me maintain the face-to-mask seal while you squeeze the bag."
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While you are transporting a patient with altered mental status, he suddenly vomits partially digested food along with large blood clots. The vomitus is too big for the rigid suction catheter. The EMT should immediately place the patient on his side and:
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perform a finger sweep
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You are by the side of a patient who fell 5 feet from a ladder, landing on a concrete porch with lower back and buttocks. Assessment reveals an intact airway, adequate respirations, rapid radial pulse, and skin that is cool and diaphoretic. The patient complains of lower back and left leg pain. No deformity to the extremity is noted; however, the lower back is tender on palpation. The following vital signs are obtained: pulse 132, respirations 20, blood pressure 102/88 mmHg, and SpO2 97% on room air. Regarding oxygen therapy, you would:
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Recognize a normal SpO2 and forego oxygen therapy.
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The EMT is properly applying continuous positive airway pressure (CPAP) when he: Checks and documents the pulse oximetry reading every 15 minutes. places the mask over the mouth and nose and tightens it to the face. places a confused patient receiving CPAP in a lateral recovery position. adjusts the ventilation rate to between 16 and 18 breaths per minute.
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places the mask over the mouth and nose and tightens it to the face.
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Which one of the following statements about the flow-restricted, oxygen-powered ventilation device is true? "It has a safety valve that prevents lung damage from overinflation." "It is an effective tool by which children can be ventilated." "It is very easy to use and has virtually no complications associated with its use." "It can be used to ventilate spontaneously breathing patients."
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"It can be used to ventilate spontaneously breathing patients."
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While a 61-year-old female in cardiac arrest receives emergency care, you note that her abdomen grows larger with each ventilation provided from a bag-valve mask. What instructions should you provide? "Let's slow the ventilation rate to 10 per minute, providing each breath over 1 second." "The ventilation rate and force of ventilation need to be increased so air goes into the lungs." "Try delivering each ventilation over 3 seconds, and let's slow down the rate." "I need another rescuer to apply firm pressure over the stomach, while we ventilate this patient."
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"Let's slow the ventilation rate to 10 per minute, providing each breath over 1 second."
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Which one of the following statements shows that the EMT knows how to properly size an oral airway prior to placement? "To select an appropriately sized oral airway, you must estimate the patient's height and weight." "It is better to have an oral airway that is too large, rather than one that is too small." "The airway should approximate the distance from the front teeth to the angle of the jaw." "An appropriately sized oral airway can be selected by looking in the patient's mouth and estimating the length of the tongue."
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"The airway should approximate the distance from the front teeth to the angle of the jaw."
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Which one of the following tips should you give a new EMT about artificially ventilating a patient with the bag-valve mask? "To direct air into the lungs and away from the stomach, flex the patient's head forward when ventilating with the BVM." "If the patient has dentures, they should be removed so a better mask-to-face seal can be achieved." "Always remove the oropharyngeal airway. If it is in place when you are ventilating with a BVM, it may be pushed deep into the airway." "It is important to maintain the head-tilt, chin-lift or jaw-thrust maneuver while ventilating the patient."
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"It is important to maintain the head-tilt, chin-lift or jaw-thrust maneuver while ventilating the patient."
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On arrival at a lethargic patient's side, you note her to have gurgling respirations. The best treatment for this condition is:
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suction.
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A 2-year-old boy who just seized must have his airway opened. When performing the head-tilt, chin-lift airway maneuver, the EMT must remember:
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The head should only be slightly extended
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You arrive at work and note that the portable oxygen tanks in the ambulance are now yellow instead of green as during the previous shift. As a knowledgeable EMT you should:
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remove the tank and retrieve a green cylinder.
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When providing oxygen via nonrebreather face mask, which one of the following is essential for the EMT to have? High-pressure regulator Therapy regulator D or E oxygen cylinder oxygen humidifier
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Therapy regulator
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When using a pocket mask to ventilate an unresponsive adult patient, the EMT must remember to always:
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maintain the head-tilt, chin-lift or jaw-thrust maneuver
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Which one of the following statements about different sizes of oxygen cylinders is true? M tanks are the easiest to carry on the stretcher D cylinders hold the most oxygen G and E tanks have the same psi when full. H tanks are the smallest oxygen cylinders
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G and E tanks have the same psi when full
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For which one of the following patients is placement of an oropharyngeal airway indicated? Unresponsive patient who has no gag or cough reflex Patient who responds to painful stimuli by moaning and has vomited Patient with snoring respirations who coughs as the oral airway is placed into his mouth Responsive but confused patient with stridorous respirations
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Unresponsive patient who has no gag or cough reflex
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The EMT shows that he is correctly using the flow-restricted, oxygen-powered ventilation device when he: ventilates the patient at a rate of 20 breaths per minute stops ventilating as soon as the patient's chest begins to rise. administers each ventilation over a 2- to 3-second period. increases pressure if the air enters the stomach instead of the lungs
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stops ventilating as soon as the patient's chest begins to rise.
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Which one of the following oxygen administration systems will provide the patient with the greatest amount of oxygen? Nasal cannula at 15 liters per minute of oxygen Nonrebreather face mask at 15 liters per minute of oxygen Simple face mask at 12 liters per minute of oxygen Venturi face mask set to deliver 40% oxygen
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Nonrebreather face mask at 15 liters per minute of oxygen
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You are using an automatic transport ventilator (ATV) for a patient who has a poor respiratory effort. Which one of the following is the best indicator of adequate ventilation? There is no air leak between the mask and the patient's face. The chest rises and falls. The inspiratory to expiratory ratio is 2 seconds to 1 second. The preset tidal and minute volumes on the ATV are being used.
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The chest rises and falls
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You must transport a patient with carbon monoxide poisoning to a specialized facility for treatment. Transport time is estimated at an hour and a half. The patient is on a nonrebreather face mask with a continuous oxygen flow of 15 lpm. On the ambulance, you have a G tank with 1,100 psi inside. Knowing that the cylinder constant is 2.41, what action should the EMT take in relation to the amount of available oxygen and transport time?
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Replace the G cylinder after the transport.
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When assessing the airway, breathing, and circulation, which one of the following best indicates that the patient has an open airway? The patient speaks with ease. The breath sounds are clear The respiratory rate is normal The patient is conscious.
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The patient speaks with ease.
question
The EMT believes that a patient is mildly hypoxic based on findings from the primary assessment. What other sign could the EMT use to confirm his suspicion of mild hypoxia? Cyanosis Responsive to verbal stimuli restlessness sleepy appearance
answer
Cyanosis
question
If an injured patient has lost all use of diaphragm, the EMT should recognize that the patient:
answer
has lost a major portion of his ability to breathe
question
A 52-year-old male with a brain tumor has gone into respiratory arrest. You assign the task of artificially ventilating the patient with the bag-valve mask to a new Emergency Medical Responder. How will you instruct him to ventilate the patient?
answer
Deliver 1 breath every 5 to 6, with each ventilation lasting 1 second.
question
The EMT should recognize that the oropharyngeal airway has been appropriately inserted when: it cannot be dislodged by the EMT vomiting is no longer occurring. the respiratory rate returns to normal its flange rests on the teeth
answer
its flange rests on the teeth
question
You are administering oxygen at 2 lpm through a nasal cannula to a confused patient. During transport, you note the SpO2 to be 91% up from 90% on scene. The patient remains confused. Your next action would be to: start positive pressure ventilation with supplemental oxygen remain at 2 lpm and continue to monitor administer oxygen at 15 lpm through a nonrebreather increase oxygen to 4 liter per minute
answer
increase oxygen to 4 liters per minute
question
Why is the jaw-thrust maneuver indicated for a patient with a possible spinal injury?
answer
it manipulates the head and cervical spine less than the head-tilt, chin-lift.
question
When providing and in-service on ventilating the geriatric patient, you should emphasize which one of the following in regards to a patient who has dentures? Loose appliances should be removed if they interfere with the airway or the seal between the mask and face It is best to leave the top appliance in place, but remove the bottom one. It is always best to remove dentures regardless of whether they are loose or not. Removal of dentures enables the EMT to maintain a better face to mask seal.
answer
Loose appliances should be removed if they interfere with the airway or the seal between the mask and face.
question
A 21-year-old female has overdosed on an unknown drug. She has snoring respirations and an intact gag reflex. She has weak respiratory effort and is slightly cyanotic. Given these assessment findings, your care should include:
answer
insertion of a nasal airway
question
Which one of the following patients is most likely to lose neurological control and regulation of the respiratory system? 31-year-old with a severe injury to the head. 61-year-old newly diagnosed with diabetes 56-year-old with heart problems and chest pain 44-year-old who smokes and is nauseated
answer
31-year-old with a severe injury to the head
question
When considering continuous positive airway pressure (CPAP), the patient must exhibit:
answer
ability to breath on his own
question
Which one of the following is a benefit of using a humidification system when administering oxygen? A higher flow rate can be used with a nasal cannula when humidification is added. Oxygen therapy is less drying to the upper respiratory tract. Increased diffusion of oxygen occurs across the respiratory membrane Humidification reduces the chances of respiratory infection.
answer
Oxygen therapy is less drying to the upper respiratory tract.
question
Which one of the following statements made by an EMT shows that she understands how to suction patients in a field setting? "It is helpful to pour sterile water into the patient's mouth to liquefy vomit and make it easier to suction." "To thoroughly suction a patient, I insert the rigid-tip catheter past the base of the tongue and into the pharynx." "When caring for a young child, I suction for a minimum of 5 seconds." "I only activate the suction device when I am withdrawing the suction catheter."
answer
"I only activate the suction device when I am withdrawing the suction catheter"
question
You are caring for a 46-year-old male patient who is unresponsive. Which one of the following statements made by your partner indicates the need to immediately stop suctioning the patient's airway and resume positive pressure ventilation? "He is starting to have gurgling respirations." "His heart rate is 48 beats per minute." "He is biting down on the rigid-tip catheter." "You have been suctioning now for 10 seconds."
answer
"You have been suctioning now for 10 seconds."
question
The EMT recognizes a late sign of hypoxia when he observes:
answer
cyanosis of the fingers
question
After 2 minutes of continuous positive airway pressure (CPAP) at 4 cmH2O, you see no improvement in the respirations or SpO2 level. You would:
answer
continue CPAP as is and monitor the patient for another 2 minutes.
question
A patient was eating dinner when he got a piece of food caught in his throat. Although coughing has failed to remove the food, he remains able to move an adequate amount of air into and out of his lungs. A nasal cannula has been applied and vital signs are stable. During transport, the patient suddenly begins to exhibit stridorous respirations. Your immediate action should be to:
answer
perform abdominal thrusts
question
Which one of the following patients should benefit from the head-tilt, chin-lift manual airway maneuver? 67-year-old female who fell down a flight of stairs and is unresponsive 45-year-old female who is alert and vomiting blood 85-year-old female who hit her head on a tree limb and is now responsive to painful stimuli 39-year-old male who just had a seizure and has snoring respirations
answer
39-year-old male who just had a seizure and has snoring respirations
question
You have arrived next to a patient who reportedly had a seizure. Assessment reveals him to be apneic with vomitus in the airway. He has a radial pulse, and his skin is cool and diaphoretic. Which of the following should you do immediately? Check breath sounds Start artificial ventilation Suction the airway Apply a nonrebreather mask
answer
Suction the airway
question
Which of the following best describes the path that oxygen must travel to get into the cells of the body? Nose, pharynx, esophagus, bronchi, alveoli Pharynx, larynx, trachea, alveoli, bronchioles Nasopharynx, oropharynx, carina, trachea, alveoli oropharynx, larynx, trachea, carina, bronchioles
answer
Oropharynx, larynx, trachea, carina, bronchioles
question
You have been called for a patient who has overdoes on drugs and alcohol. The patient is responsive to painful stimuli and is breathing shallowly at 8 times per minute, but exhibits no cyanosis. you should recognize and do which one of the following? Adequate breathing; administer oxygen at 15 lpm through a nonrebreather face mask. adequate breathing; initiate positive pressure ventilation with supplemental oxygen Inadequate breathing; administer oxygen at 15 lpm through a nonrebreather face mask inadequate respirations; start positive pressure ventilation with supplemental oxygen.
answer
Inadequate respirations; start positive pressure ventilation with supplemental oxygen.
question
You are teaching a group of firefighters who are in class to become Emergency Medical Responders. The topic is artificial ventilation with the bag-valve mask (BVM). Which one of the following points related to using the BVM should you emphasize. The bag must be fully squeezed in order to give the proper amount of volume with each breath. The BVM is useless unless it is hooked to supplemental oxygen. Maintaining a good mask-to-face seal is difficult. It is better to ventilate too quickly as opposed to too slowly
answer
Maintaining a good mask-to-face seal is difficult.
question
Which one of the following statements about a nasal cannula is true? "It is best to see how the patient tolerates the nasal cannula before attempting to place a nonrebreather mask on the patient." "I can adjust the oxygen flow rate anywhere form 1 to 81 lpm, depending on how much oxygen the patient needs." "When the nasal cannula is set to the highest appropriate oxygen flow rate, a large portion of the air inspired by the patient is ambient air." "The nasal cannula is preferred over the nonrebreather mask because it gives the oxygen through the nose instead of the mouth."
answer
"When the nasal cannula is set to the highest appropriate oxygen flow rate, a large portion of the inspired air by the patient is ambient air."
question
You are artificially ventilating an adult male patient who is in respiratory arrest with a bag-valve mask. Which of the following shows that you are ventilating this patient properly? Ability to fully deflate the self-inflating bag Clear and equal breath sounds Adequate chest rise and fall Ventilation rate of 20 breaths per minute
answer
Adequate chest rise and fall
question
Which one of the following statements made by an EMT shows he understands the use of the pocket mask?
answer
"In comparison to the bag-valve mask, the pocket mask can deliver a just as good, if not better, tidal volume."
question
What disease process would CPAP be most beneficial to?
answer
CHF with moderate to severe dyspnea
question
Which of the following statements regarding airway management in the trauma patient is correct?
answer
Performing the head-tilt, chin-lift maneuver on a patient with a possible spinal injury could further injure or paralyze the patient.
question
Which one of the following setups on the bag-valve mask will enable the EMT to deliver the highest concentration of oxygen to the patient?
answer
BVM with oxygen attached, receiving oxygen at 15 lpm
question
Which one of the following statements indicates that that the EMT has a correct understanding of the use of oxygen in the prehospital setting?
answer
"Oxygen should never, ever be withheld from a patient you think may need it."
