airway respirations 3

Your patient is a 33 year old female who fell off the back of a motorcycle going approximately 20 MPH. Her respirations are irregular at 8 a minute. An OPA has been inserted and ventilations are being assisted with a BVM and 100% O2 at a rate and tidal volume of________________________. C-Spine precautions have been taken and she is packaged and moved to the ambulance where she stops breathing and there is no palpable pulse. CPR is started and the lead paramedic does a rapid sequence intubation. The BVM is attached to the ET tube and ventilations are restarted at a rate of ______________________________________________.

10 to 12 breaths per minute. Tidal volume of just enough air to give adequate chest rise. / 8 to 10 breaths per minute without pauses in compressions.

Respirations in an adolescent would be considered normal at ____________

16 breaths per minute According to the NES (National Education Standards) adolescence (13-18 years) begins at the onset of puberty until adulthood. The respiratory rate for this age group is 12-20 per minute.

Your patient is an unresponsive 44 year old female who has a pulse but is not breathing. How should you proceed with CPR?

2 quick rescue breaths and then provide 10-12 breaths per minute AHA guidelines state that If she has a pulse, you only want to provide ventilatory support with 2 rescue breaths and 10-12 breaths per minute.

Dispatch has just called you to Medical Park where a man has fallen out of his wheel chair. You and your partner Sheila arrive to find two bystanders doing CPR on an approximately 60 y/o male. When you begin CPR, what rate and depth of compressions will you use?

30:2 / 2 inches

Which patient is most viable?

5 y/o who fell through the ice and was submerged for 10 minutes before being brought to your ambulance. She is not breathing and doesn't have a pulse.

Below what percentage of oxygen saturation would you consider a patient hypoxic?

95 percent

You have an unconscious patient. What do you do?

ABCs, History taking, Rapid full body scan

Pulmonary ventilation includes all of the following except:

Anaerobic respiration Pulmonary ventilation includes: External respiration, internal respiration, cellular respiration, and metabolism.

1. You and your partner Trevor arrive on scene of a gang stabbing. Law enforcement says they have secured the area. You move in to assess two patients in their teens who both have stab wounds to their chests and abdomens. You would immediately?

Apply a 3 sided dressing to the chest wounds and assess breathing

Crackles

Are a sign of lower respiratory obstruction

You are called to a daycare where a 3 year old boy is reportedly unconscious after choking on a plastic toy. You arrive to find the child lying supine on the floor with the caregiver attempting to give artificial ventilations. "I can't get any air in!", she says. With a quick inspection of the mouth, you can partially see a deeply lodged object near the glottis. What should you do now?

Begin chest compressions in an attempt to dislodge the object. Check airway regularly.

A conscious alert adult is breathing at 22 respirations per minute. You should __________.

Check oxygen delivery and coach them to slow their breathing

n elderly female patient has adequate respiratory depth with good quality and rate, but her SPO2 reading is at 90%. Which of the following is the most likely cause of this low reading? How are you going to treat her?

Chemoreceptors slowing down because of advanced age. / Put her on a nasal canula at 5 LPM

Respiration occurs within the respiratory system, however other structures, not part of the system, are needed to accomplish respiration. Which list includes only those structures that support respiration?

Chest cage, ribs, intercostal muscles, diaphragm, pleura, and phrenic nerve

The pediatric assessment triangle is composed of three elements:

Circulation, Appearance, Work of Breathing

Which breath sounds would you likely hear from a person whose alveoli contain fluid?

Crackles

Gastric distention may interfere with ventilations while in the field and can cause?

Decreased lung expansion Gastric rupture Increased resistance to BVM ventilations ALL OF THE ABOVE

During anaphylaxis the vessels of the circulatory system __________________ while the passages of the airway _______________.

Dilate /swell

Which direction does the diaphragm move when a person breathes in?

Down

Paradoxical motion of the chest during exhalation is often an indication of what type of injury?

Flail segment

Without any further information, what condition would you say the following patient is in? A 7-year-old male with a pulse rate of 90, breathing at 25 breaths per minute, and a systolic BP of 100.

Good All vitals are within normal limits for a child of this age. NES guidelines state that for a child 6-12 the heart rate is 70-110, respirations 20-30 and BP is 80-120.

Which statement best describes the Bronchi?

Hollow tubes that further divide into the lower airways of the lungs and are supported by cartilage.

There are two separate respiratory drives. The ______________________ and the ___________________. If a COPD patient is a carbon dioxide retainer then_______________________

Hypoxic / Carbon dioxide / You should deliver oxygen via nasal canula at 4-6 LPM

Your patient is a 75 year old male who may have had a stroke. He is unconscious and breathing with snoring respirations. After performing a head tilt chin lift maneuver, the snoring is still present. What is your best course of action?

Insert a nasopharyngeal, measured from the nostril to the earlobe

OPA's and NPA's can become ineffective at maintaining the airway if you don't?

Keep the head in the proper position

You have responded to Qwik-mart for a possible allergic reaction. As you pull into the parking lot you see a man lying outside the store with the clerk and two other bystanders standing to the side. As you approach, you see the patient has an unused Epinephrine auto injector clutched in his hand. His respirations are shallow at about 8 breaths a minute and he only responds with slight moans when given a sternal rub. His pulse is weak at 50 beats per minute and his blood pressure is 110/80. What would be the most appropriate treatment for this patient?

Mouth to mask ventilations at 10-12 per minute

Which of the following is NOT indicated in a 7 year old child who has suffered a basilar fracture after falling from a bicycle?

Nasopharyngeal airway

You and your partner arrive on scene to find a 9 year old with a possible basilar fracture of the skull. Which of the following would be contraindicatedd in this patient?

Nasopharyngeal airway

You are dispatched to a possible cardiac arrest. You arrive 10 minutes from the time of the call. You and your partner enter the residence to find a man in his 50's lying supine on the living room floor. His wife says that he "just collapsed" while eating dinner. Which of the following treatment choices is most appropriate at this time according to AHA Guidelines?

Perform 30 compressions and then look inside the mouth before attempting to ventilate

Which of the following is a sign that your patient could be perfusing poorly?

Poor mentation

The epiglottis serves which function?

Protects the airway of a conscious patient during swallowing

Patients with tracheal stomas may necessitate different ventilation techniques than those without tracheostomies. Which of the following statements is true with regard to these ventilation techniques?

Sealing the mouth and nose of a patient while delivering a ventilation through a stoma and then unsealing the mouth and nose during passive exhalation can be an effective assisted ventilatory technique

A person having breathing difficulties may show __________.

Straining of facial muscles

You and your partner Gene respond to a report of a car vs. pedestrian. An elderly man has been struck by a car and is now on the sidewalk lying supine. Gene takes C-spine and you begin an initial assessment noticing that the man's breathing is fast and very shallow. He does not respond to you and also has some liquid or vomit running from his mouth. The best choice of action would be?

Suction his mouth

The larynx is ______________ to the trachea.

Superior

Use of an SpO2 monitor on a person suffering from carbon monoxide poisoning will be inaccurate because ___________.

The carbon monoxide molecule displaces the oxygen molecule inhibiting oxygen delivery

911 dispatch calls you to the scene of a "man down". You arrive to find a man sitting up against the wall of his garage. He has a glazed look in his eyes and abnormal respirations. The breaths begin slow and shallow and then gradually get faster and deeper. The rate and depth then decrease to the point of apnea. What do you suspect is wrong with this patient? What are you going to do for them?

They had a stroke / Give high flow oxygen Cheyne-Stokes is the name associated with the breathing pattern in this question. It is most often associated with stroke and metabolic problems. Periods of apnea and or irregular breaths can also point to stroke. The obvious first intervention for this patient is to administer oxygen.

Besides being the center of speech, what other function do the vocal cords perform?

They protect the lower airway.

During inspiration, the air enters the nose and then proceeds:

Through the nasopharynx and then the larynx into the trachea then the bronchi and alveoli

Which of the following choices is not part of the respiratory system?

Thyroid

Cheyne-Stokes breathing is characterized by __________.

Uneven breaths with periods of apnea

You and your partner Wanda arrive on scene to find a male patient complaining of dyspnea. The caretaker attending the man verifies he has COPD and is currently on oxygen at 4 lpm by nasal canula. Upon assessing respirations, you note the man is breathing at a rate of 30 breaths per minute and his tidal volume is very shallow. What should you do?

Ventilate via BVM with attached O2 at a tidal volume around 500 mL per breath

You arrive on scene with your partner Mark to find your patient, a 68 year old man who is unconscious and has a pulse of 140. He is cyanotic around his mouth and down his neck and appears to be breathing very shallow at 6 per minute. Your actions would include?

Ventilation with a BVM with attached O2 at 15 lpm

All of the following are functions of the mouth and oral cavity except:

Warms and humidifies air

You are preparing to suction secretions from your patient's airway, when would you engage the suction action in the catheter?

While suctioning secretions and withdrawing the catheter

Which situation would indicate using the Jaw Thrust maneuver?

hen a cervical spinal injury is suspected.

During inspiration, the air enters the nose and then proceeds:

through the nasopharynx and then the larynx into the trachea then the bronchi and alveoli

What would you do if a newborn infant has a heart rate lower than 100 beats a minute?

ventilate at 40-60 breaths a minute