Airway/Respiration
What actions would you take if your patient becomes apneic? -Begin Bag Valve Mask ventilations (ambu) -Immediately place the patient in a prone position -Place the patient on a nasal cannula -Stop all resuscitation efforts
begin Bag valve mask ventilations
Inadequate breathing or inadequate blood circulation can cause: -Kyphosis -Lordosis -Hyperglycemia -Hypoxia
Hypoxia
What is dyspnea? -difficulty swallowing -difficulty talking -difficulty breathing -difficulty eating
difficulty breathing
You are placing an OPA in a semi-conscious patient and they start to gag. What should you do next? -Assure them its OK -Tape the OPA in place -Immediately remove the OPA -Reposition the OPA
immediately remove the OPA
Which of the following is true regarding suctioning a patient's airway? -Never suction the airway for longer than 15 seconds -Suction only as you insert the catheter into the mouth -BSI precautions are not important if there is no visible blood -You may suction the airway for more than 30 seconds at a time
never suction the airway for longer than 15 seconds
Which of the following is not a true statement? -The oropharyngeal airway should be selected for an unconscious patient -the oropharyngeal airway is a better choice for a patient who is having seizures -a conscious patient is likely to experience the gag reflex with the use of an oropharyngeal airway -the nasopharyngeal airway is less likely to stimulate the gag reflex
the oropharyngeal airway is a better choice for a patient who is having seizures
Anatomic differences in a child's respiratory system can make openings and maintaining the airway a difficult and challenging process. Which of the following choices correctly states some of the problems and solutions associated with these anatomical differences: -A child's pharynx is larger in proportion to that of an adult's and easily blocked by swelling or mucous. Using a nasopharyngeal will assist in passing these blockage and making the airway patent -A child's tongue is larger and takes up considerably more room in the mouth. using a tongue depressor to hold the tongue down while inserting an OPA without rotating it will be more effective then techniques used in adults -A child's cricoid cartilage is larger and less flexible than that of an adult making it more susceptible to blockage. Using a flexible or French catheter to suction the cricoid opening will aid in making the airway patent. -A child's larynx sits more posterior and superior in the throat making it easier for the tongue to fall back and block the trachea. Putting a rolled up towel under the child's head can help align the oropharynx and trachea which will assist in ventilations
-A child's tongue is larger and takes up considerably more room in the mouth. using a tongue depressor to hold the tongue down while inserting an OPA without rotating it will be more effective then techniques used in adults
How should you ventilate a patient with a bag valve mask (ambu bag)? -Aggressively, given them all the air available in the BVM -With only as much ventilation needed to adequately provide adequate chest rise -Until medical control says to use the AED -Only after you know the patient is apneic
-With only as much ventilation needed to adequately provide adequate chest rise
A 23-year-old male experienced severe head trauma after his motorcycle collision with an oncoming truck. He is conscious, has a rapid and shallow breathing pattern, and is producing copious bloody secretions from his mouth. How would you manage his airway? -Suction his oropharynx with a rigid catheter until all secretions are removed -insert a nasopharyngeal airway, provide suction and assisted ventilations -alternate 15 seconds of oral suctioning with two minutes and assisted ventilations -provide continuous ventilations with a BVM device to minimize tissue hypoxia
-alternate 15 seconds of oral suctioning with two minutes and assisted ventilations
Which the following would be most important when attempting to ventilate a patient with facial trauma: -tilt the head back to properly ventilate the patient -establish a nasopharyngeal airway immediately -have a suctioning device close by in case significant blood or vomit needs to be suctioned out of the airway -immediately place the patient on his right side to avoid bleeding into the oropharynx
-have a suctioning device close by in case significant blood or vomit needs to be suctioned out of the airway
You arrive on scene with your partner Kevin to find a seven year old boy unconscious after being dragged from the water. He is not breathing and has no pulse. CPR in this case should be performed at? -30:2 compression to ventilation ratio -15:2 compression to ventilation ratio -5:1 compression to ventilation ratio -30:1 compression to ventilation ratio
15:2 compression to ventilation ratio
When the liter flow on a bag-valve mask unit is set at 15 liters per minute, what is the approximate concentration of oxygen delivered to the patient? -16% -50% -24% -90-100%
90-100%
What must you do first before inserting an oral pharyngeal airway? -Lubricate it with petroleum gel -Measure it from the nose to the earlobe -Measure it from the lip to the earlobe -Measure it from the lip to the temporal
Measure it from the lip to the earlobe
The first step of emergency care in the patient with inadequate breathing is: -Checking for the patient's pulse. -Manually stabilizing the cervical spine -Opening and maintaining the patient's airway. -Looking for and controlling severe bleeding
Opening and maintaining the patients airway
Signs of inadequate breathing include all of the following except: -Retractions above the clavicles, between ribs, and below rib cage -Cyanosis of the lips, ear lobes, or nail beds -Bradypnea -Pink skin and respiratory rate between 12 and 20 per minute
Pink skin and respiratory rate b/w 12 and 20 per minute
A nasal cannula should be used to deliver oxygen to a patient who: -has severe trouble breathing -is having a severe heart attack requires a high concentration of oxygen. - requires a high concentration of oxygen. requires a high concentration of oxygen -requires low amounts of oxygen
Requires low amounts of oxygen
Which of the following is not a sign of labored breathing: -diminished breath sounds -use of accessory muscles to breathe -an adult with a respiratory rate of 12 press per minute -an infant with a respiratory rate of 12 press per minute
an adult with a respiratory rate of 12 press per minute
A female patient with a suspected spinal injury is breathing with marked reduction in tidal volume. The most appropriate airway management for her includes: -hyperventilating with 30 breaths a minute -administering oxygen via non-rebreather -ventilation assistance to maintain the saturation of 90% -assisting ventilations at an age-appropriate rate
assisting ventilations at an age-appropriate rate
Because the oropharyngeal airway (OPA) is likely to stimulate the patient's gag reflex, the rescuer should: -Select a larger size OPA -be prepared to suction -use the next smaller size OPA -tape the OPA in place
be prepared to suction
The lower airway ends at the Alveoli, where gas exchange occurs. Oxygen moves to the hemoglobin by passing through a semipermeable membrane. Where does this occur? -Capillary bed -Bronchioles -Capillary blood -Veinules
capillary bed
Oropharyngeal airways can be used on unconscious patients, except those who -Are in cardiac arrest -Have a gag reflex -Are younger than 8 years -Have a contagious respiratory disease
have a gag reflex
A 24-year-old female patient has fallen from the roof of her house and is unconscious. The best method of opening her airway is the _____ maneuver. -head-tilt, chin-lift -head-tilt, neck-lift head-tilt, neck-lift head-tilt, neck-lift -modified jaw-thrust -tongue-chin lift
modified jaw-thrust
The nasopharyngeal airway (NPA) is often utilized because it: -Comes in more sizes than the oropharyngeal airway -Often does not stimulate the patient's gag reflex -Can be used in head trauma patients -Can be reused
often doesn't stimulate the patients gag reflex
Which of the following ventilatory techniques is likely to yield the LOWEST tidal volumes? -One person bag-valve-mask -Two person bag-valve-mask -Flow restricted oxygen powered ventilatory device -Mouth-to-mask
one person bag-valve mask
The tongue often is a source of airway obstruction; it falls back and occludes the _________? -Larynx -Trachea -Nasopharynx -Pharynx
pharynx
A six-year-old female was riding her bike and struck a clothesline with her throat. She is breathing, with obvious difficulty. Your rapid trauma assessment reveals a crackling sensation in the soft tissue of her neck and facial cyanosis. In addition to appropriate airway management, the intervention that will most likely improve her chances survival is: -request a paramedic ambulance -careful monitoring of her vital signs -rapidly transporting her to the hospital -quickly immobilizing her spinal column
rapidly transporting her to the hospital
The inability to move enough air required for adequate perfusion is known as what? -Respiratory Arrest -Respiratory Failure -Cardiac Failure -Pleurisy
respiratory failure
Stimulation of the back of a patient's throat when suctioning may cause: -Convulsions -Unequal pupils -Slowed heart rate -Cyanosis
slowed heart rate
A 71-year-old male is unconscious following a sudden, severe headache. There was vomitus on his face and he is breathing with shallow, slow respirations. The most appropriate initial airway management for this patient is to: -insert a nasopharyngeal airway -assist breathing with BVM -suction airway -apply oxygen via non-rebreather mask
suction airway
You come across a scene where the patient appears to be in respiratory distress and is making a gurgling noise. You immediately know that you need to: -place a king airway in this patient -suction the patient immediately -log roll the patient -perform chest thrust on the patient
suction the patient immediately
Which of the following would be considered an indicator of adequate ventilation? -the patient's skin has a bluish tinge -the patient has a heart rate of 120 bpm -the patient has a distended abdomen -the patient is being ventilated at minimal 12 breaths per minute
the patient is being ventilated at minimal 12 breaths per minute
You are assisting ventilations via Bag Valve Mask (ambu) device. How can you determine that your ventilations are effective? -The patient becomes cyanotic. -The patient vomits -The patient's chest is rising and falling with each ventilation. -The pulse oximeter goes from 86% to 80%.
the patient's chest is rising and falling with each ventilation
You are dispatched to a local nursery for a 39-year-old female who is sick. When you arrive, you find the patient lying on the floor. She is semiconscious, has copious amounts of saliva coming from her mouth, and is incontinent of urine. You quickly feel her pulse and note that it is very slow. Initial management for this patient should include: -assisting her ventilations via BVM -thoroughly suctioning oropharynx -performing a rapid medical assessment -request a paramedic to give her atropine
thoroughly suctioning oropharynx
Which of the following is the most effective method for administering ventilations to an apneic patient? -Two person bag-valve-mask -Mouth-to-nose -One person bag-valve-mask -Mouth-to-mouth
two person bag-valve mask
Which situation would indicate using the Jaw Thrust Maneuver? -When a cervical spinal injury is suspected -When a clavicle fracture is suspected -When a brain injury is suspected -When a mandibular fracture is suspected
when a cervical spinal injury is suspected