EMT Chapter 10: Airway Management

Questions and Answers

What should you do if a woman regurgitates large amounts of vomit while being ventilated with a bag-valve mask?

Roll her onto her side and remove the oral airway.

For which patients is CPAP indicated?

Patients who have pulmonary edema and can follow verbal commands.

How is hypoxia defined?

Inadequate O2 to the tissues and cells.

How does positive-pressure ventilation affect cardiac output?

It increases intrathoracic pressure, which decreases venous return to the heart and causes a decrease in cardiac output. Signup and view all the answers

What is the most serious complication of using a nasopharyngeal airway in a patient with head trauma?

Penetrating the cranium. Signup and view all the answers

When is a nasal cannula most appropriately used in the prehospital setting?

When the patient cannot tolerate a nonrebreathing mask. Signup and view all the answers

What process do cells use to convert glucose into energy in the presence of oxygen?

Aerobic metabolism. Signup and view all the answers

What is the normal respiratory rate for an adult at rest?

12-20 breaths/min. Signup and view all the answers

What can help minimize the risk of gastric distention when ventilating an apneic patient?

Avoiding increasing the amount of delivered tidal volume. Signup and view all the answers

What is tidal volume defined as?

The volume of air that moves into/out of the lungs in a single breath. Signup and view all the answers

What is the most appropriate treatment for a conscious patient experiencing a foreign body airway obstruction?

Encouraging him to cough and transporting. Signup and view all the answers

The __________ cartilage is a firm ring that forms the inferior part of the larynx.

Cricoid. Signup and view all the answers

What is the jaw-thrust maneuver used for?

To open the airway of patients with suspected cervical spine injuries. Signup and view all the answers

What should you do for a patient in respiratory distress who is conscious but unable to follow simple verbal commands?

Assist his ventilations with a BVM. Signup and view all the answers

Which patient would most likely require insertion of an oropharyngeal airway?

A 40-year-old unconscious patient with slow, shallow respirations. Signup and view all the answers

What is oxygen toxicity?

Cellular tissue damage occurs from excessive O2 levels in the blood. Signup and view all the answers

Which factor would NOT cause a decrease in tidal volume?

Deep respirations. Signup and view all the answers

What condition occurs if ventilation is impaired?

Hypercarbia. Signup and view all the answers

Where does the actual exchange of oxygen and carbon dioxide occur?

In the alveolar sacs. Signup and view all the answers

What is the purpose of the pin-indexing system for compressed gas cylinders?

To ensure that the correct regulator is used for the cylinder. Signup and view all the answers

On which type of patient would it be most appropriate to use a flow-restricted, oxygen-powered ventilation device?

A 21-year-old male with traumatic cardiac arrest. Signup and view all the answers

In which situation should supplemental oxygen be administered according to current guidelines?

Exposure to carbon monoxide and an O2 saturation of 95%. Signup and view all the answers

What does passive ventilation refer to during the first few minutes of working on a cardiac arrest patient?

Allowing recoil of the chest between compressions to draw air into the lungs. Signup and view all the answers

How does CPAP improve oxygenation and ventilation in patients?

It forces the alveoli open and pushes more O2 across the alveolar membrane. Signup and view all the answers

What is the advantage of placing an unresponsive patient in the recovery position?

It helps to maintain a clear airway. Signup and view all the answers

What should you do if you are unable to effectively ventilate a critically injured patient?

Begin ventilations using the mask-to-mouth technique (portable mask). Signup and view all the answers

Which oxygen flowmeter is NOT affected by gravity?

Bourdon-gauge flowmeter. Signup and view all the answers

What does wheezing indicate when assessing a patient with respiratory distress?

A lower airway obstruction. Signup and view all the answers

What should you do while ventilating a patient with a stoma?

Seal the mouth and nose. Signup and view all the answers

What are complications associated with using a manually triggered ventilation device?

Lung tissue injury and gastric distention. Signup and view all the answers

What is a late sign of hypoxia?

Cyanosis. Signup and view all the answers

In which case would the head tilt-chin lift maneuver be most appropriate?

A 37-year-old female found unconscious in her bed. Signup and view all the answers

What is the most reliable indicator of adequately performed bag-mask ventilations in an apneic adult with a pulse?

Adequate rise of the chest when squeezing the bag. Signup and view all the answers

The pressure of gas in a full cylinder of oxygen is approximately _______ pounds per square inch (psi).

2,000 psi. Signup and view all the answers

Which patient is breathing adequately?

Conscious, pink skin, 19 breaths/min. Signup and view all the answers

What should you do if your partner shows signs of choking and has a weak cough?

Stand behind him and administer abdominal thrusts. Signup and view all the answers

What is external respiration?

The process of exchanging oxygen and carbon dioxide between alveoli and blood. Signup and view all the answers

Which condition can cause an increase in the amount of exhaled carbon dioxide?

Anaerobic metabolism. Signup and view all the answers

What is a correct statement regarding oxygen?

O2 supports combustion and may cause a fire. Signup and view all the answers

Why must an unconscious patient found in a prone position be placed supine?

So he or she can receive CPR if necessary. Signup and view all the answers

What influences the hypoxic drive for patients with chronic respiratory diseases?

Low blood O2 levels. Signup and view all the answers

What type of mask should a hypoxic patient who is breathing adequately be given?

A nonrebreathing mask. Signup and view all the answers

What happens during inhalation?

The diaphragm and intercostal muscles contract and cause a decrease in intrathoracic pressure. Signup and view all the answers

The diaphragm is innervated by the _________ nerve, which allows it to contract.

Phrenic. Signup and view all the answers

If an apneic patient's blood pressure decreases significantly while ventilating, what should you do?

Reevaluate the rate and volume of your ventilations. Signup and view all the answers

What is true regarding positive-pressure ventilation?

More volume is required to have the same effects as normal breathing. Signup and view all the answers

Calculate the minute volume for a patient with a tidal volume of 500 mL, a dead space volume of 150 mL, and a respiratory rate of 16 breaths/min.

5,600 mL. Signup and view all the answers

Who should be placed in the recovery position?

A 31-year-old semiconscious male with low blood sugar and adequate breathing. Signup and view all the answers

Which structure is NOT found in the upper airway?

Bronchus. Signup and view all the answers

What should be administered to a patient presenting with difficulty breathing who is conscious?

100% O2 via a nonrebreathing mask. Signup and view all the answers

What occurs during intrapulmonary shunting?

Blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state. Signup and view all the answers

What is a ventilation/perfusion (V/Q ratio) mismatch?

Disruption of blood flow inhibits exchange of O2 and CO2 in the lungs, even though alveoli are filled with fresh O2. Signup and view all the answers

What is the most significant complication associated with oropharyngeal suctioning?

Hypoxia due to prolonged suction. Signup and view all the answers

The partial pressure of oxygen in the alveoli is _ mm Hg, while the partial pressure of carbon dioxide in the alveoli is _ mm Hg.

104/40. Signup and view all the answers

At a flow rate of 6 L/min, what approximate oxygen concentration can a nasal cannula deliver?

44%. Signup and view all the answers

What is your first action when finding an unconscious patient in a prone position?

Log roll him as a unit into a supine position. Signup and view all the answers

Which structure is NOT part of the lower airway?

Epiglottis. Signup and view all the answers

With a good mask-to-face seal and an oxygen flow rate of 15 L/min, a nonrebreathing mask is capable of delivering up to ______% inspired oxygen.

<ol start="90"> <li></li> </ol> Signup and view all the answers

What should be done if a patient begins to gag violently while inserting an oropharyngeal airway?

Remove the airway and be prepared to suction her oropharynx. Signup and view all the answers

When should an oxygen cylinder be taken out of service and refilled?

When the pressure inside it is less than 500 psi. Signup and view all the answers

Which organ or tissue can survive the longest without oxygen?

Muscle. Signup and view all the answers

When does the diaphragm function as an involuntary muscle?

When a person sleeps. Signup and view all the answers

What statement regarding oxygenation and ventilation is correct?

In mines or confined spaces where O2 levels are low, ventilation may continue despite adequate oxygenation. Signup and view all the answers

What is the main advantage of the Venturi mask?

The use of its fine adjustment capabilities in the long-term management of physiologically stable patients. Signup and view all the answers

What should you do if adequate chest rise is present while ventilating a patient with dentures?

Remove her dentures, resume ventilations, and assess for adequate chest rise. Signup and view all the answers

Why is a nasopharyngeal airway considered beneficial?

It can maintain a patent airway in a semiconscious patient with a gag reflex. Signup and view all the answers

What is true regarding the one-person bag-mask device technique?

Adequate tidal volume is often difficult to achieve when one EMT is operating the BVM. Signup and view all the answers

What are Cheyne-Stokes respirations?

Irregular respirations characterized by an increasing rate and depth of breathing followed by periods of apnea. Signup and view all the answers

When testing a mechanical suctioning unit, what vacuum pressure should it generate?

More than 300 mm Hg. Signup and view all the answers

What feedback do central chemoreceptors in the medulla provide?

They increase the rate and depth of breathing when they sense slight elevations in CO2 or a decrease in the pH of the CSF. Signup and view all the answers

What should you do if a patient receiving CPAP shows increased heart rate and confusion?

Remove the CPAP device and ventilate him with a BVM. Signup and view all the answers

What is the preferred initial method of providing ventilations for an apneic patient?

The mouth-to-mask technique with a one-way valve. Signup and view all the answers

Which structure is contained within the mediastinum?

Esophagus. Signup and view all the answers

What percentage of oxygen is a patient receiving when performing mouth-to-mask ventilations at 15 L/min?

55%. Signup and view all the answers

What should you do to prevent gastric distention while assisting with respirations?

Ensure that the patient's airway is appropriately positioned, ventilate at the appropriate rate, and ventilate at the appropriate volume. Signup and view all the answers

What must be ensured prior to applying a nonrebreathing mask?

The reservoir bag is fully inflated. Signup and view all the answers

How is a nasopharyngeal airway inserted?

With the bevel facing the septum (if inserted into the right nare). Signup and view all the answers

What will cause a decreased minute volume in an adult?

Shallow breathing. Signup and view all the answers

What happens during exhalation compared to inhalation?

Exhalation is a passive process caused by increased intrathoracic pressure. Signup and view all the answers

How should you manage the airway of a patient with severe head trauma who has rapid and shallow breathing?

Alternating 15 seconds of oral suctioning with 2 minutes of assisted ventilation. Signup and view all the answers

What method will you use to keep the airway open for an unconscious patient who was hit by a heavy construction vehicle?

Oropharyngeal. Signup and view all the answers

Study Notes

Airway Management Key Concepts

Inserting an oral airway and performing bag-valve mask ventilation can lead to complications such as regurgitation; rolling the patient onto their side helps manage this.
Continuous Positive Airway Pressure (CPAP) is beneficial for patients with pulmonary edema who can communicate.
Hypoxia is defined as the insufficiency of oxygen reaching tissues and cells.
Positive-pressure ventilation reduces cardiac output by increasing intrathoracic pressure, hindering venous return.
Using a nasopharyngeal airway in head or facial trauma increases the risk of penetrating the cranium.
Nasal cannula is suitable when the patient cannot tolerate a nonrebreathing mask, typically used for low-flow oxygen delivery.

Breathing Mechanics and Interventions

Aerobic metabolism is the process by which cells use oxygen to convert glucose into energy.
Normal respiratory rates for adults range from 12 to 20 breaths per minute.
To minimize gastric distention during bag-valve mask ventilation, maintain appropriate tidal volume without excessive delivery.
Tidal volume represents the volume of air inhaled or exhaled in one breath.
In conscious patients with foreign body obstruction, encourage coughing and transport; it indicates effective airway clearance.

Airway Devices and Techniques

The cricoid cartilage forms the lower boundary of the larynx and provides structural support.
For suspected cervical spine injuries, use the jaw-thrust maneuver to maintain airway patency.
Assist ventilation with a bag-mask device for patients exhibiting severe respiratory distress and low oxygen saturation.
Unconscious patients with shallow respirations may require insertion of an oropharyngeal airway for effective airway maintenance.

Oxygenation and Ventilation

Oxygen toxicity can lead to cellular damage from excessively high oxygen levels.
Deep respirations do not inherently decrease tidal volume, whereas conditions like obstructive breathing do.
Impaired ventilation increases carbon dioxide in the bloodstream, a condition known as hypercarbia.
Alveolar sacs are the sites of gas exchange between oxygen and carbon dioxide.
The pin-indexing system ensures compatibility between regulators and gas cylinders.

Patient Management and Assessments

Use passive ventilation during the initial minutes of cardiac arrest care to draw air into the lungs.
CPAP improves oxygenation by keeping alveoli open and enhancing gas exchange.
The recovery position maintains a clear airway while preventing aspiration in unresponsive patients.
Complications such as lung tissue injury and gastric distention may arise from manually triggered ventilation devices.
Hypoxia manifests late in its progression as cyanosis, indicating critical oxygen deficiency.

Techniques and Emergency Evaluations

Use the head tilt-chin lift maneuver for non-trauma unresponsive patients to open their airway effectively.
Adequate chest rise when bag-mask ventilating indicates successful air delivery.
Oxygen cylinders operate at high pressure, usually around 2,000 psi when full.
Patients exhibiting stable vital signs and adequate respirations should be placed in recovery positions for monitoring.

Advanced Respiratory Concepts

Intrapulmonary shunting occurs when blood bypasses non-functional alveoli, returning unoxygenated to the left heart.
Ventilation/perfusion (V/Q) mismatches occur when blood flow abnormalities prevent efficient gas exchange despite healthy alveolar function.
Oxygen levels must be monitored closely to avoid fires, as they support combustion.
Muscle tissue has a higher tolerance to oxygen deprivation compared to other organs, enabling it to survive longer without oxygen.

Specific Conditions and Patient Responses

Use a mouth-to-mask technique for ventilating apneic patients as the preferred primary method to ensure effective air delivery.
An unconscious prone patient must be log-rolled to supine to facilitate potential CPR needs.
Administer supplemental oxygen with nonrebreathing masks for patients presenting with hypoxia and high respiratory rates.
The diaphragm's innervation through the phrenic nerve controls involuntary breathing, essential during sleep.
Shallow breathing results in decreased minute volume, impacting overall ventilation efficiency.

Emergency Procedures and Responses

Effective management of airway in patients with trauma may involve alternating suctioning and assisted ventilation to ensure airway clearance.
A combination of oral suctioning and ventilation timing of 15 seconds and 2 minutes is recommended for managing copious oral secretions.
Ensure proper positioning and inflation of reservoir bags for nonrebreathing masks to guarantee maximum oxygen delivery.

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Description

Test your knowledge on airway management with this quiz focused on EMT Chapter 10. Review critical concepts such as the use of oral airways, managing patients in respiratory distress, and recognizing signs of hypoxia. Perfect for aspiring EMTs or those preparing for exams!