Wheezing can be described as _______________.
Answer(s): A
Wheezing is produced by narrowing or obstruction of the lower airways, which often causes a high-pitched, whistling sound as the air travels through the narrowed space. Stridor is another sound that can often be heard even without a stethoscope and can indicate an obstruction, but it is a brassy, crowing sound.
You’re responding to a call for a 44-year-old woman who is complaining of feeling anxious and states, “I can’t breathe.” You should do the following:
Answer(s): C
The patient is breathing since she is talking. There is no need to manually ventilate her at this time. You should perform a respiratory assessment including checking oxygenation.
When assessing breathing, tidal volume refers to _______________.
Tidal volume is the amount of air a person inhales with one breath or how deeply they are breathing.
You are treating an adult patient who is unresponsive and just vomited. You need to suction his airway. You should suction the patient’s airway for no more than _______________ at a time.
According to the Red Cross and the book most often used in EMS courses (see references below, new publication 2016), suctioning an adult’s airway should be limited to 15 seconds at a time. Suctioning interferes with oxygenation and can lead to hypoxia. Suctioning sessions may have to be repeated to remove all material necessary, but never suction the mouth or nose for more than 15 seconds at one time for adult patients. Suctioning times are 10 seconds for children and 5 seconds for infants.Note that we have had reports of a new standard for adult suctioning that has been reduced to 10 seconds, but we cannot find evidence of this change in any reliable materials. We have also been told that the answer choices will be ranges of time, so choose 10-15 seconds and you should be fine.References: American Academy of Orthopaedic Surgeons (AAOS) (2016-02-12). Emergency Care and Transportation of the Sick and Injured. Jones & Bartlett Learning. (the book most often used in EMT courses) and the Red Cross, page 83 of the booklet: http://www.lbtbp.com/wp-content/uploads/2017-CPR-Part-1.pdf
References: American Academy of Orthopaedic Surgeons (AAOS) (2016-02-12). Emergency Care and Transportation of the Sick and Injured. Jones & Bartlett Learning. (the book most often used in EMT courses) and the Red Cross, page 83 of the booklet: http://www.lbtbp.com/wp-content/uploads/2017-CPR-Part-1.pdf
If manually ventilating a patient, you should squeeze the bag every _____ seconds for an adult and every _____ seconds for a child.
To maintain adequate perfusion, manual ventilation should be performed at a rate of 1 breath every 5 to 6 seconds in an adult, for a total of 10 to 12 breaths a minute. In a child, manual ventilation should be performed at a rate of 1 breath every 3 to 5 seconds, for a total of 12 to 20 breaths per minute.
A nasal cannula can be run at how many LPM?
A flow of over 6 LPM will not increase the delivered FiO2 and may dry the mucus membranes and be uncomfortable. If higher flow rates are needed to maintain adequate oxygen levels, switch to another device, such as a simple mask or non-rebreather.
You are manually ventilating a patient using a bag-valve-mask (BVM). The patient is connected to a pulse oximetry and the oxygen saturation reading is 80. You do not see the chest rise. What steps can you take?
Answer(s): D
To ensure ventilations are effective, make sure the airway is open by repositioning the head. It’s also essential to have a tight seal between the patient’s face and the mask or air will escape and not be delivered to the patient’s lungs.
You’re on scene at a high school football game. A football player collapsed to the ground. He has a pulse, a respiratory rate of 4 breaths per minute, breaths are very shallow and he is grunting slightly. Airway management should include _______________.
The patient is not ventilating adequately. A RR of 4 is too low and he needs ventilatory support. Placing a non-rebreather or nasal cannula will not be sufficient since he has a poor spontaneous respiratory effort. While the “grunting” may be an indicator of an obstruction, it would not be a reason to withhold manual ventilation.
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