EMT Chapter 11 Airway Management Quiz

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Questions and Answers

A patient who is suspected of being hypoxic and is breathing adequately should be given supplemental oxygen with a:

  • Nasal cannula
  • Mouth-to-mask device
  • Bag-mask device
  • Nonrebreathing mask (correct)

A 51-year-old female presents with a sudden onset of difficulty breathing. Her respirations are 22 breaths/min and regular. You should:

  • Perform a secondary assessment and then begin treatment
  • Assist her ventilations with a bag-mask device
  • Insert a nasal airway in case her mental status decreases
  • Administer oxygen via a nonrebreathing mask (correct)

Which of the following patients should you place in the recovery position?

  • A 40-year-old conscious female with a possible neck injury and regular respirations
  • A 19-year-old conscious male with a closed head injury and normal respirations
  • A 31-year-old semiconscious male with low blood sugar and adequate breathing (correct)
  • A 24-year-old unconscious female who overdosed and has a reduced tidal volume

You are ventilating a patient with a stoma; however, air is escaping from the mouth and nose. To prevent this, you should:

<p>Seal the mouth and nose (A)</p> Signup and view all the answers

How does CPAP improve oxygenation and ventilation in patients with certain respiratory problems?

<p>It forces the alveoli open and increases the concentration of oxygen in the alveoli (D)</p> Signup and view all the answers

In the presence of oxygen, the cells convert glucose into energy through a process called:

<p>Aerobic metabolism (A)</p> Signup and view all the answers

When testing a mechanical suctioning unit, you should turn on the device, clamp the tubing, and ensure that it generates a vacuum pressure of more than:

<p>300 mm Hg (D)</p> Signup and view all the answers

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

<p>cricoid</p> Signup and view all the answers

Which of the following statements regarding breathing adequacy is correct?

<p>Patients breathing shallowly may require assisted ventilation despite a normal respiratory rate (D)</p> Signup and view all the answers

The nasal cannula is MOST appropriately used in the prehospital setting:

<p>When the patient cannot tolerate a nonrebreathing mask (A)</p> Signup and view all the answers

In contrast to inhalation, exhalation:

<p>Is a passive process caused by increased intrathoracic pressure (C)</p> Signup and view all the answers

All of the following will help minimize the risk of gastric distention when ventilating an apneic patient with a bag-mask device, EXCEPT:

<p>Increasing the amount of delivered tidal volume (D)</p> Signup and view all the answers

The MOST significant complication associated with oropharyngeal suctioning is:

<p>Hypoxia due to prolonged suction attempts (C)</p> Signup and view all the answers

What is the alveolar minute volume of a patient with a tidal volume of 500 mL, a dead space volume of 150 mL, and a respiratory rate of 16 breaths/min?

<p>5,600 mL (D)</p> Signup and view all the answers

The partial pressure of oxygen in the alveoli is _______ mm Hg; the partial pressure of carbon dioxide in the alveoli is _______ mm Hg.

<p>104, 40</p> Signup and view all the answers

You are ventilating an apneic woman with a bag-mask device. Adequate chest rise is present with each ventilation. When you reassess the patency of her airway, you note that her dentures are now loose. You should:

<p>Remove her dentures, resume ventilations, and assess for adequate chest rise (D)</p> Signup and view all the answers

You are performing bag-mask ventilations with oxygen connected and set at a flow rate of 15 L/min. What percentage of oxygen are you delivering?

<p>Nearly 100% (D)</p> Signup and view all the answers

The purpose of the pin-indexing system for compressed gas cylinders is to:

<p>Ensure that the correct regulator is used for the cylinder (D)</p> Signup and view all the answers

Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense:

<p>Slight increases in carbon dioxide or a decrease in the pH of the cerebrospinal fluid (B)</p> Signup and view all the answers

Which of the following statements regarding positive-pressure ventilation is correct?

<p>With positive-pressure ventilation, more volume is required to have the same effects as normal breathing (D)</p> Signup and view all the answers

Hypoxia is MOST accurately defined as:

<p>Inadequate oxygen to the tissues and cells (B)</p> Signup and view all the answers

Which of the following patients would MOST likely require insertion of an oropharyngeal airway?

<p>A 40-year-old unconscious patient with slow, shallow respirations (C)</p> Signup and view all the answers

Intrapulmonary shunting occurs when:

<p>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 (C)</p> Signup and view all the answers

Prior to applying a nonrebreathing mask to a patient, you must ensure that the:

<p>Reservoir bag is fully inflated (A)</p> Signup and view all the answers

While providing CPAP to a patient in severe respiratory distress, you note that his heart rate has increased by 20 beats/min. You should:

<p>Remove the CPAP device and ventilate him with a bag-mask device (C)</p> Signup and view all the answers

To select the proper size oropharyngeal airway, you should measure from the:

<p>Corner of the mouth to the earlobe (B)</p> Signup and view all the answers

The actual exchange of oxygen and carbon dioxide occurs in the:

<p>Alveolar sacs (A)</p> Signup and view all the answers

In which of the following patients would the head tilt-chin lift maneuver be the MOST appropriate method of opening the airway?

<p>A 37-year-old female who is found unconscious in her bed (A)</p> Signup and view all the answers

For which of the following conditions would the EMT most likely administer humidified oxygen?

<p>Croup (C)</p> Signup and view all the answers

The process of exchanging oxygen and carbon dioxide between the alveoli and the blood of the capillaries is called:

<p>External respiration (D)</p> Signup and view all the answers

An adult at rest should have a respiratory rate that ranges between:

<p>12 and 20 breaths/min (B)</p> Signup and view all the answers

High-flow oxygen with a nasal cannula during the preoxygenation phase of endotracheal intubation is called:

<p>Apneic oxygenation (D)</p> Signup and view all the answers

An oxygen cylinder should be taken out of service and refilled when the pressure inside it is less than:

<p>500 psi (D)</p> Signup and view all the answers

Gas exchange in the lungs is facilitated by:

<p>Adequate amounts of surfactant (C)</p> Signup and view all the answers

At a flow rate of 6 L/min, a nasal cannula can deliver an approximate oxygen concentration of up to:

<p>44% (A)</p> Signup and view all the answers

Irregular respirations characterized by an increasing rate and depth of breathing followed by periods of apnea are called:

<p>Cheyne-Stokes respirations (B)</p> Signup and view all the answers

Oxygen toxicity is a condition in which:

<p>Cellular tissue damage occurs from excessive oxygen levels in the blood (C)</p> Signup and view all the answers

Structures of the lower airway include all of the following, EXCEPT:

<p>The epiglottis (B)</p> Signup and view all the answers

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

<p>phrenic</p> Signup and view all the answers

The hypoxic drive is influenced by:

<p>Low blood oxygen levels (D)</p> Signup and view all the answers

The presence of elevated carbon dioxide levels in the blood is called:

<p>Hypercarbia (A)</p> Signup and view all the answers

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

<p>90</p> Signup and view all the answers

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

<p>2,000</p> Signup and view all the answers

Which of the following structures is NOT found in the upper airway?

<p>Bronchus (A)</p> Signup and view all the answers

What is the MOST common cause of airway obstruction in an unconscious patient?

<p>The tongue (D)</p> Signup and view all the answers

Which of the following patients is breathing adequately?

<p>A conscious male with respirations of 19 breaths/min and pink skin (D)</p> Signup and view all the answers

Which of the following factors will cause a reduction in minute volume in an adult?

<p>Shallow breathing (B)</p> Signup and view all the answers

Which of the following oxygen flowmeters is NOT affected by gravity and can be used in any position when attached to an oxygen cylinder?

<p>Bourdon-gauge flowmeter (D)</p> Signup and view all the answers

Which of the following is a late sign of hypoxia?

<p>Cyanosis (A)</p> Signup and view all the answers

Which of the following organs or tissues can survive the longest without oxygen?

<p>Muscle (A)</p> Signup and view all the answers

Flashcards

Supplemental Oxygen Delivery

Providing extra oxygen to patients whose breathing is adequate but who are experiencing low oxygen levels.

Oxygen Administration for Difficulty Breathing

Using a non-rebreathing mask to deliver oxygen to patients who are struggling to breathe but can still talk.

Recovery Position

Positioning a semiconscious patient with normal breathing on their side to ensure an open airway and prevent choking on vomit.

Stoma Ventilation

Sealing the mouth and nose of a patient with a stoma to prevent air escape during ventilation.

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CPAP Function

Continuous Positive Airway Pressure (CPAP) helps keep the tiny air sacs in the lungs (alveoli) open during breathing, improving oxygen exchange.

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Aerobic Metabolism

Cells use oxygen to convert glucose into energy, which is essential for all bodily functions.

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Respiratory Rates

Healthy adults normally take 12 to 20 breaths per minute at rest.

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Suctioning Requirements

Mechanical suction devices should be able to pull with a force of over 300 mm Hg to effectively remove fluids from the airway.

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Oropharyngeal Airway Sizing

Measure the distance from the corner of the patient's mouth to their earlobe to determine the correct size for an oropharyngeal airway.

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Gas Exchange

Oxygen and carbon dioxide exchange happens in the tiny air sacs (alveoli) in the lungs, facilitated by a special substance called surfactant.

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Breathing Adequacy

Shallow breathing, even with a normal respiratory rate, can indicate a need for assisted ventilation.

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Complications of Suctioning

The main risk of suctioning the airway is low oxygen levels (hypoxia) caused by prolonged suctioning.

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Oxygen Flow Rates

Delivering oxygen through a nasal cannula at a flow rate of 6 L/min provides an oxygen concentration of approximately 44%.

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Unconscious Patient Care

The tongue is the most common obstruction of the airway in unconscious patients. Positioning the head or using an oropharyngeal airway can help.

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Adjusting for Illness

Patients with conditions like croup may benefit from humidified oxygen to relieve symptoms.

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Signs of Hypoxia

Early signs of low oxygen levels (hypoxia) include restlessness and anxiety. Bluish skin (cyanosis) indicates more severe hypoxia.

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Positive Pressure Ventilation

Delivering breaths with positive pressure requires a bigger volume of air compared to normal breathing.

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Mechanical Ventilation

Use a bag-mask device with a good seal and oxygen flow to provide nearly 100% oxygen during skilled interventions.

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Monitoring Patient Response

If a patient on CPAP shows an increased heart rate and reduced responsiveness, switch to bag-mask ventilation.

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Regulator Connection

Connect regulators correctly to oxygen cylinders to ensure safe and effective oxygen administration.

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Oxygen Cylinder Management

Replace oxygen cylinders when the pressure drops below 500 psi to ensure a continuous supply.

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Hypoxia

Insufficient oxygen available to tissues and cells, which can lead to serious health problems.

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Hypercarbia

High levels of carbon dioxide in the blood, leading to respiratory acidosis if not managed.

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Respiration

The process by which oxygen is taken into the lungs and carbon dioxide is expelled from the body.

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Alveoli

The part of the respiratory system responsible for the exchange of gases between the air and the blood.

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Surfactant

A substance that reduces surface tension in the alveoli, preventing them from collapsing.

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Homeostasis

The process by which the body attempts to maintain a stable internal environment.

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Nasal Cannula

A medical device that delivers oxygen to a patient through the nose.

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Croup

A condition characterized by inflammation of the airways, causing difficulty breathing and a barking cough.

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Ventilator

A device that provides artificial ventilation to patients who are unable to breathe on their own.

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Suctioning

A procedure used to remove fluids and secretions from the airway.

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Study Notes

Airway Management Key Concepts

  • Supplemental Oxygen Delivery: Hypoxic patients with adequate breathing should receive oxygen via a nonrebreathing mask to ensure high oxygen concentration.
  • Oxygen Administration: For patients who have difficulty breathing but can speak, administering oxygen through a nonrebreathing mask is crucial due to their increased respiratory rate.
  • Recovery Position: Use the recovery position for semiconscious patients with normal breathing to maintain an open airway and prevent aspiration.
  • Stoma Ventilation: Seal the mouth and nose when ventilating a patient with a stoma to prevent air escape during respiratory support.

Physiology of Breathing

  • CPAP Function: Continuous Positive Airway Pressure (CPAP) maintains alveoli open during inhalation, enhancing oxygen exchange.
  • Aerobic Metabolism: Cells convert glucose into energy using oxygen, which is critical for cellular function.
  • Respiratory Rates: Adults typically have a resting respiratory rate of 12 to 20 breaths per minute.

Mechanical and Anatomical Aspects

  • Suctioning Requirements: Verify that mechanical suction units can generate a vacuum pressure of over 300 mm Hg for effective suctioning.
  • Oropharyngeal Airway Sizing: Measure the airway from the corner of the mouth to the earlobe for proper sizing.
  • Gas Exchange: The exchange of oxygen and carbon dioxide occurs in the alveolar sacs, facilitated by the presence of surfactant.

Clinical Indicators and Interventions

  • Breathing Adequacy: Shallow breathing may warrant assisted ventilation, despite a normal respiratory rate. Signs of adequate breathing can include normal skin color and respiratory rate around 19 breaths/min.
  • Complications of Suctioning: The primary complication of oropharyngeal suctioning is hypoxia from prolonged suction attempts; careful technique is essential.
  • Oxygen Flow Rates: Delivering oxygen through a nasal cannula at a flow rate of 6 L/min can provide about 44% oxygen concentration.

Patient Assessment and Treatment

  • Unconscious Patient Care: The tongue is the most common cause of airway obstruction in unconscious patients; positioning the head or using an oropharyngeal airway can manage this.
  • Adjusting for Illness: Patients with conditions such as croup may benefit from humidified oxygen to alleviate symptoms.
  • Signs of Hypoxia: Early signs include restlessness and anxiety, with cyanosis indicating more severe hypoxia.

Emergency Procedures

  • Positive Pressure Ventilation: Requires increased volume to be effective compared to normal breathing. Proper technique improves patient outcomes.
  • Mechanical Ventilation: Use a bag-mask device and ensure good seal and oxygen flow to provide nearly 100% oxygen during skilled interventions.
  • Monitoring Patient Response: If a patient under CPAP shows an increased heart rate and altered responsiveness, switch to bag-mask ventilation.

Oxygen Management

  • Regulator Connection: Properly connect regulators to ensure safe and effective oxygen administration; pin-indexing guarantees correct regulator use.
  • Oxygen Cylinder Management: Replace and refill cylinders when the pressure drops below 500 psi to maintain availability.

Important Definitions

  • Hypoxia: Defined as inadequate oxygen available to tissues and cells, which may lead to serious health complications if not addressed promptly.
  • Hypercarbia: Refers to elevated levels of carbon dioxide in the blood, potentially leading to respiratory acidosis if not managed.

These notes summarize the essentials of airway management and respiratory physiology crucial for EMTs and first responders. Understanding these principles and practices can significantly impact patient care outcomes.

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