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EMT-B Chapter 9 – Airway Management

Moves down slightly when it contracts
diaphragm
Irregular breathing pattern with increased rate and depth followed by apnea
Cheyne-Stokes
Active part of breathing
Inhalation
Voice box
larynx
Amount of air moved during one breath
tidal volume
Raises ribs when it contracts
intercostal muscle
Space between the lungs
mediastinum
Site of oxygen diffusion
alveoli
Thorax size decreases
exhalation
Insufficient oxygen for cells and tissues
hypoxia
Backup system to control respiration
hypoxic drive
Exchange of air between lungs and the environment
ventilation
What percentage of the air we breathe is made up of oxygen?
a. 78%
b. 12%
c. 16%
d. 21%
D
Regarding the maintenance of the airway in an unconscious adult, which of the following is false?
a. insertion of an oropharyngeal airway helps keep the airway open
b. the head tilt-chin lift maneuver should always be used to open the airway
c. secretions should be suctioned from the mouth, as necessary
d. inserting a rigid suction catheter beyond the tongue may cause gagging
B
The normal respiratory rate for an adult is:
a. about equal to the person’s heart rate
b. 12 to 20 breaths/min
c. faster when the person is sleeping
d. the same as in infants and children
B
All of the following are signs of hypoxia except:
a. tachycardia
b. dehydration
c. cyanosis
d. weak pulse
B
The brain stem normally triggers breathing by increasing respirations when:
a. carbon dioxide levels increase
b. oxygen levels increase
c. carbon dioxide levels decrease
d. nitrogen levels decrease
A
Which of the following is not a sign of abnormal breathing?
a. warm, dry skin
b. speaking in two- or three-word sentences
c. unequal breath sounds
d. skin pulling in around the ribs during inspiration
A
The proper technique for sizing an oropharyngeal airway before insertion is to measure the device from:
a. the tip of the nose to the earlobe
b. the bridge of the nose to the tip of the chin
c. the corner of the mouth to the earlobe
d. the center of the jaw to the earlobe
C
What is the most common problem you may encounter when using a bag-mask device?
a. volume of the bag-mask device
b. positioning of the patient’s head
c. environmental conditions
d. maintaining an airtight seal
D
When ventilating a patient with a bag-mask device, you should:
a. look for inflation of the cheeks
b. look for signs of the patient breathing on his or her own
c. look for rise and fall of the chest
d. listen for gurgling
C
Suctioning the oral cavity of an adult should be accomplished within:
a. 5 seconds
b. 10 seconds
c. 15 seconds
d. 20 seconds
C
Which of the following is the preferred method of assisting ventilations?
a. mouth-to-mask with one-way valve
b. two-person bag-mask device with reservoir and supplemental oxygen
c. flow-restricted, oxygen-powered ventilation device
d. one-person bag-mask device with oxygen reservoir and supplemental oxygen
A
When a person goes __________ minutes without oxygen, brain damage is very likely.
a.. 0-4
b. 4-6
c. 6-10
d. more than 10
C
If your partner, while examining a patient, states that the patient’s lungs are equal and bilateral, you would understand your partner to mean that:
a. both lungs have labored breathing
b. both lungs are equally bad
c. the patient is not breathing
d. there are clear and equal lung sounds on both sides
D
What are agonal gasps?
a. occasional gasping breaths, but adequate to maintain life
b. occasional gasping breaths, unable to maintain life
c. painful respirations due to broken ribs
d. another name for ataxic respirations
B
You come upon an unresponsive patient who is not injured and is breathing on her own with a normal rate and an adequate tidal volume. What would be the advantage of placing her in the recovery position?
a. it’s the preferred position of comfort for patients
b. it helps to protect their cervical spine when injuries are hidden
c. it helps to maintain a clear airway
d. it’s easier to load them onto the cot from this position
C
T/F Nasal airways keep the tongue from blocking the upper airway and facilitate suctioning of the oropharynx.
F
T/F Nasal cannulas can deliver a maximum of 44% oxygen at 6 L/min.
T
T/F Oral airways should be measure from the tip of the nose to the earlobe.
F
T/F Compressed gas cylinders pose no unusual risk.
F
T/F The pin-indexing system is used to ensure compatibility between pressure regulators and oxygen flowmeters.
F
Air enters the body through the __________ _______ __________.
mouth and nose
In exhalation, air pressure in the lungs is __________ than the pressure outside.
higher
The air we breathe contains __________ percent oxygen and _________ percent nitrogen.
21; 78
The primary mechanism for triggering breathing is the level of _________ __________ in the blood.
carbon dioxide
During inhalation, the __________ and __________ _________ contract, causing the thorax to enlarge.
diaphragm; intercostal muscles
Continuous __________ Airway __________ has proven to be immensely beneficial to patients experiencing respiratory distress from acute pulmonary edema or obstructive pulmonary disease.
positive; pressure
Insufficient oxygen in the cells and tissues is called _________.
hypoxia
Absence of spontaneous breathing
apnea
The space in between the vocal cords that is the narrowest portion of the adult’s airway
glottis
The process of delivering oxygen to the blood by diffusion from the alveoli following inhalation into the lungs
oxygenation
A safety system for large oxygen cylinders, designed to prevent the accidental attachment of a regulator to a cylinder containing the wrong type of gas, is known as the _________ Standard System
american
_________ pressure can be applied to occlude the esophagus to inhibit gastric distention and regurgitation of vomitus in the unconscious patient.
cricoid
__________ ventilation is the volume of air moved through the lungs in 1 minute, minus the dead space, and is calculated by multiplying tidal volume (minus dead space) and respiratory rate
minute
The metabolism that takes place in the absence of oxygen is called ___________ metabolism; the principle product is lactic acid
anaerobic
The amount of air that can be forcibly expelled from the lungs after breathing in as deeply as possible is known as the __________ capacity
vital
A liquid protein substance that coats the alveoli in the lungs, decreases alveolar surface tension, and keeps the alveoli expanded; a low level in a premature infant contributes to respiratory distress syndrome
surfactant
_________ respirations are irregular, ineffective respirations that may or may not have an identifiable pattern
ataxic
__________ exchange is a term used to distinguish the degree of distress in a patient with a mild airway obstruction. The patient is still conscious and able to cough forcefully, although wheezing may be heard.
goodair
A ventilation device attached to a control box that allow the variables of ventilation to be set. It frees the EMT to perform other tasks while the patient is being ventilated
atv
Occasional, gasping breaths that occur after the heart has stopped are known as _________ respirations
agonal
An opening through the skin and into an organ or other structure; one in the neck connects the trachea directly to the skin
stoma
Increased carbon dioxide level in the bloodstream
hypercarbia
A life-threatening collection of air within the pleural space is called a(n) ___________ pneumothorax
tension
A dangerous condition in which the body tissues and cells do not have enough oxygen
hypoxia
The term used to describe the amount of gas in air or dissolved in fluid, such as blood, is __________ pressure
partial
Mechanical maintenance of pressure in the airway at the end of expiration to increase the volume of gas remaining in the lungs
peep
Point at which the trachea divides into the left and right mainstem bronchi
carina
A method of ventilation used primarily in the treatment of critically ill patients with respiratory distress; can prevent the need for endotracheal intubation
cpap
You respond to a construction site and find a worker lying supine in the dirt. He has been hit by a heavy construction vehicle and flew more than 15′ before landing in his current position. There is discoloration and distention of his abdomen about the RUQ. He is unconscious and his respirations are 10 breaths/min and shallow, with noisy gurgling sounds. What airway technique will you use to open his airway?
a. head tilt-neck lift maneuver
b. jaw thrust
c. head tilt-chin lift maneuver
d. none of the above
B
You respond to a construction site and find a worker lying supine in the dirt. He has been hit by a heavy construction vehicle and flew more than 15′ before landing in his current position. There is discoloration and distention of his abdomen about the RUQ. He is unconscious and his respirations are 10 breaths/min and shallow, with noisy gurgling sounds. After opening the airway, your next priority is to:
a. provide oxygen at 6L/min via nonrebreathing mask
b. provide oxygen at 15L/min via nasal cannula
c. assist respirations
d. suction the airway
D
You respond to a construction site and find a worker lying supine in the dirt. He has been hit by a heavy construction vehicle and flew more than 15′ before landing in his current position. There is discoloration and distention of his abdomen about the RUQ. He is unconscious and his respirations are 10 breaths/min and shallow, with noisy gurgling sounds. What method will you use to keep his airway open?
a. nasal cannula
b. jaw thrust
c. oropharyngeal airway
d. any of the above
C
You respond to a construction site and find a worker lying supine in the dirt. He has been hit by a heavy construction vehicle and flew more than 15′ before landing in his current position. There is discoloration and distention of his abdomen about the RUQ. He is unconscious and his respirations are 10 breaths/min and shallow, with noisy gurgling sounds. While assisting with respirations, you note gastric distention. In order to prevent or alleviate the distention, you should:
a. ensure that the patient’s airway is appropriately positioned
b. ventilate the patient at the appropriate rate
c. ventilate the patient at the appropriate volume
d. all of the above
D
You respond to a construction site and find a worker lying supine in the dirt. He has been hit by a heavy construction vehicle and flew more than 15′ before landing in his current position. There is discoloration and distention of his abdomen about the RUQ. He is unconscious and his respirations are 10 breaths/min and shallow, with noisy gurgling sounds. The correct ventilation rate for assisting this adult patient is:
a. one breath every 5-6 seconds
b. one breath every 3-5 seconds
c. one breath every 10-12 seconds
d. there is no need to assist with ventilations for this patient
A
What are 5 early signs of hypoxia?
1. restlessness
2. tachycardia
3. irritability
4. anxiety
5. apprehension
What are the normal respiratory rate for adults, children, and infants?
adults: 12-20 breaths/min
children: 15-30 breaths/min
infants: 25-50 breaths/min
How can you avoid gastric distention while performing artificial ventilation?
give slow, gentle breaths
What are 5 components of a manually triggered ventilation device?
1. a peak flow rate of 100% oxygen at up to 40L/min
2. an inspiratory pressure safety release valve that opens at approximately 60cm of water and vents any remaining volume to the atmosphere or stops the flow of oxygen
3. an audible alarm that sounds whenever you exceed the relief valve pressure
4. the ability to operate satisfactorily under normal and varying environmental conditions
5. a trigger positioned so that both your hands can remain on the mask to provide an airtight seal while supporting and tilting the patient’s head and keeping the jaw elevated
What are 6 signs of inadequate breathing?
1. respiratory rate of less than 12 breaths/min or greater than 20 breaths/min
2. accessory muscle use
3. skin pulling in around the ribs during inspiration
4. pale, cyanotic, or cool (clammy) skin
5. irregular rhythm
6. diminished, absent, or noisy breath sounds
What are accessory muscles? Name 3.
they are secondary muscles of respiration and are not used in normal breathing.
1. neck muscles
2. chest muscles
3. abdominal muscles
When should medical control be consulted before inserting a nasal airway?
when the patient has experienced severe trauma to the head or face
What are the 4 steps in nasal airway insertion?
1. select the proper-size airway and apply a water-soluble lubricant
2. place the airway in the larger nostril with the curvature following the curve of the floor of the nose
3. advance the airway gently
4. continue until the flange rests against the skin
What is the best suction tip for suctioning the oropharynx, and why?
tonsil tips are best because they have a larger diameter and do not collapse and are curved, which allows easy, rapid placement
What is the time limit for each episode of suctioning an adult?
15 seconds
after performing a head tilt-chin life maneuver to open the airway of an unresponsive patient, you should:
suction as needed and insert an airway adjunct
if a patient develops diff breathing after your primary assessment, you should immediately:
reevaluate his airway status
which of the following actions would not be performed during the scene size up?
rapidly assessing a patient’s respiratory status
the diastolic pressure represents the:
minimum amount of pressure that is always present in the arteries
a 40 y/o male crashed his motorcycle into a tree. He is a semiconscious has snoring respirations, and has a laceration to the forearm with minimal bleeding. you should:
open his airway with the jaw-thrust maneuver
when a patient’s respiration’s are shallow:
tidal volume is markedly reduced
when using the pulse oximeter as part of your assessment of a patient, it is important to remember that:
any situation that causes vasoconstriction or loss of RBC’s, such as anemia or bleeding, and may result in an inaccurate or misleading value
you are dispatched to the county jail for an inmate who is “sick.” when you arrive, you find the patient, a 33 y/o male, unresponsive. his airway is patent and his respiration’s are rapid. your initial action should be to:
provide assisted ventilation
which of the following abnormal breath sounds indicates obstruction of the upper airway:
stridor
Hypotension in a child with blunt or penetrating trauma is particularly significant because:
it often indicates the loss of half of his or her Blood volume
An oxygen cylinder should be taken out of service and refilled when the pressure inside it is less than:
500 psi
Which of the following 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
Pulmonary edema and impaired ventilation occur during:
cardiogenic shock
You are performing mouth-to-mask ventilations with oxygen connected and set at a flow rate of 15 L/min. What percentage of oxygen is your patient receiving?
55%
A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer 100% oxygen and give him epinephrine via subcutaneous injection. Upon reassessment, you determine that his condition has not improved. You should:
repeat the epi injection after consulting with medical control
A ventilation/perfusion (V/Q ratio) mismatch occurs when:
a disruption in blood flow inhibits the exchange of oxygen and carbon dioxide in the lungs, even though the alveoli are filled with fresh oxygen.
The partial pressure of oxygen in the alveoli is _______ mm Hg, while the partial pressure of carbon dioxide in the alveoli is _______ mm Hg.
A) 90, 50
B) 104, 40
C) 88, 30
D) 70, 28
104, 40
Capillary sphincters are:
circular muscular walls that regulate blood flow through the capillaries.
Which of the following clinical signs is unique to anaphylactic shock?
wheezing
A 27-year-old male was stabbed in the chest during a disagreement at a poker game. As you approach him, you see that a knife is impaled in his chest. Before you make physical contact with the patient, it is MOST important to:
follow standard precautions/BSI
The __________ cartilage is a firm ring that forms the inferior part of the larynx.
cricoid
Clinical signs of compensated shock include all of the following, EXCEPT:
absent peripheral pulses
Gas exchange in the lungs is facilitated by:
adequate amounts of surfactant
At a flow rate of 6 L/min, a nasal cannula can deliver an approximate oxygen concentration of up to:
44%
A 51-year-old female presents with a sudden onset of difficulty breathing. She is conscious and alert and able to speak in complete sentences. Her respirations are 22 breaths/min and regular. You should:
administer 100% oxygen via a NRM mask
You are transporting a 33-year-old male who was involved in a motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should:
reassess his condition in 5 minutes/
perform a physical examination
A 59-year-old male presents with severe vomiting and diarrhea of 3 days’ duration. He is confused and diaphoretic, and his radial pulses are absent. His blood pressure is 78/50 mm Hg. After applying 100% supplemental oxygen, you should:
prepare for immediate transport
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:
300 mm Hg
The primary waste product of aerobic metabolism is:
carbon dioxide
The pressure of gas in a full cylinder of oxygen is approximately _______ pounds per square inch (psi).
2000
What is the 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?
5600 mL
In an acute injury setting, neurogenic shock is commonly accompanied by:
hypothermia
How does CPAP improve oxygenation and ventilation in patients with certain respiratory problems?
It forces the alveoli open and pushes more oxygen across the alveolar membrane.
shock is the result of
hypoperfusion to the cells of the body
A 23-year-old male experienced severe head trauma after his motorcycle collided with an oncoming truck. He is unconscious, has rapid and shallow breathing, and has copious bloody secretions in his mouth. How should you manage his airway?
alternate 15 seconds of oral suctioning with 2 mins of assisted ventilation
To select the proper size oropharyngeal airway, you should measure from the:
corner of the mouth to the earlobe
The MOST significant complication associated with oropharyngeal suctioning is:
hypoxia due to prolonged suction attempts
When perfusion to the core of the body decreases:
blood is shunted away from the skin
A nasopharyngeal airway is inserted:

A) into the smaller nostril with the tip following the roof of the nose.
B) into the larger nostril with the tip pointing away from the septum.
C) with the bevel facing the septum if inserted into the right nare.
D) with the bevel pointing downward if inserted into the left nare.

C) with the bevel facing the septum if inserted into the right nare.
You are ventilating a patient with a stoma; however, air is escaping from the mouth and nose. To prevent this, you should:

A) thoroughly suction the stoma.
B) ventilate with less pressure.
C) thrust the jaw forward.
D) seal the mouth and nose.

seal the mouth and nose
Central chemoreceptors located in the medulla provide feedback to increase the rate and depth of breathing when they sense:
slight elevations in carbon dioxide or a decrease in the pH of the cerebrospinal fluid.
After establishing that an adult patient is unresponsive, you should:
assess for breathing
The MOST appropriate treatment for a patient with a mild upper airway obstruction includes:
administering oxygen and transporting immediately
What is the correct ratio of compressions to ventilations when performing two-rescuer child CPR?
15:2
A patient should be placed in the recovery position when he or she:
is unconscious, uninjured, and breathing adequately
after ___ minutes without oxygen, brain damage is likely.
6
After ___ minutes without oxygen, brain damage is irreversible.
10
The main benefit of using a mechanical piston or load-distributing band device for chest compressions is:
the elimination of rescuer fatigue that results from manual compressions
When assessing the pulse of an unresponsive infant, you should palpate the ________ artery.
brachial
A 60-year-old male is found to be unresponsive, pulseless, and apneic. You should:
begin CPR until an AED is available
After the patient’s airway is intubated during two-rescuer CPR, you should:
deliver one rescue breath every 6-8 seconds
In two-rescuer adult CPR, you should deliver a compression to ventilation ratio of:
30:2
Signs of a sudden severe upper airway obstruction include all of the following, EXCEPT:
A. grasping the throat.
B. forceful coughing.
C. inability to speak.
D. acute cyanosis.
forceful coughing
Which of the following statements regarding ventricular fibrillation (V-fib) is MOST correct?
A. AEDs should not be used to defibrillate patients in V-fib.
B. It is an uncommon dysrhythmia in patients with sudden cardiac arrest.
C. The only indication for immediate defibrillation is V-fib.
D. Survival rates decrease by 7% to 10% for each minute that V-fib persists.
D. survival rates decrease by 7% to 10% for each minute that V-fib persists.
Several attempts to adequately open a trauma patient’s airway with the jaw-thrust maneuver have been unsuccessful. You should:
carefully perform the head tilt-chin lift maneuver
Which of the following is NOT a BLS intervention?
cardiac monitoring
In MOST cases, cardiopulmonary arrest in infants and children is caused by:
respiratory arrest
What is the minimum number of chest compressions that should be delivered per minute to a 4-month-old infant?
100
CPR will NOT be effective if the patient is:
prone
Which of the following is NOT an indication to stop CPR once you have started?
A. Care is transferred to a bystander.
B. Pulse and respirations return.
C. You are physically exhausted.
D. A physician directs you to do so.
A. Care is transferred to a bystander.
You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient takes a deep breath and depresses the inhaler, you should:
instruct him to hold his breath for as long as he comfortably can
In addition to looking for severe bleeding, assessment of circulation in the conscious patient should involve:
checking the radial pulse and noting the color, temperature, and condition of his or her skin.
Which of the following statements regarding anaphylaxis is correct?
Anaphylaxis is characterized by airway swelling and hypotension.
End-tidal carbon dioxide (ETCO2) monitoring is clearly indicated for patients who present with:
respiratory distress
Weakening of the airway in patients with chronic bronchitis is the result of:
destruction of protective mechanisms that remove foreign particles
asthma is caused by a response of the:
immune system
When auscultating the lungs of a patient with respiratory distress, you hear adventitious sounds. This means that the patient has:
abnormal breath sounds
You are dispatched to a residence for a 67-year-old female who was awakened by shortness of breath and sharp chest pain. Her husband tells you that she was recently discharged from the hospital after having hip surgery. Your assessment reveals dried blood around her mouth, facial cyanosis, and an oxygen saturation of 88%. This patient’s presentation is MOST consistent with:
acute pulmonary embolism
In what area of the lungs does respiration occur?
alveoli
harsh high-pitched inspiratory sounds are characteristic of:
stridor
What does the upper airway consist of?
Nose, Mouth, Jaw, Oral Cavity, Pharynx, and Larynx
What is the main function of the upper airway?
to warm, filter, and humidify the air that enters the body
What does the Pharynx consist of?
Nasopharynx, Oropharynx, and Laryngopharynx
What does the Lower Airway consist of?
Trachea, Bronchi, and Lungs
What is the main function of the lower airway?
to exchange Oxygen and Carbon Dioxide
What is in the Mediastinum?
Heart and Great Vessels, Esophagus, Trachea, Major Bronchi, and Nerves
What is Ventilation?
Physical act of breathing
What is Oxygenation?
process of loading oxygen molecules onto hemoglobin molecules in the bloodstream
What is Respiration?
Actual exchange of oxygen and carbon dioxide in the alveoli as well as the tissue of the body
What is Inhalation?
Muscular Part of breathing, diaphragm and intercostal muscles contract
What is partial pressure?
amount of gas in the air or dissolved fluid
The Partial Pressure of oxygen in air residing the alveoli is
104 mmHg
What regulates breathing?
the pH level in the cerebrospinal fluid
Oxygenation is required for ______ to take place.
internal respiration
Cells take energy from nutrients via ___
metabolism
Where does pulmonary respiration take place?
capillaries
Chemoreceptors monitor the levels of _____.
Oxygen, Carbon Dioxide, Hydrogen Ions, and pH of cerebrospinal fluid
What happens when ventilation is compromised but perfusion continues? What is the result?
not all alveoli are enriched with oxygen
Results in hypoxemia.
What happens when Perfusion across the aveolar membrane is disrupted? What is the result?
Disruption in the blood flow does not allow for optimal exchange in gases across the membrane
Results in hypoxemia
Intrinsic factors affecting pulmonary ventilation
Infections, allergic reactions, and unresponsiveness.
Results in hypoxia and hinder adequate tissue perfusion
Medication factors affecting pulmonary ventilaton
lower respiration rate and tidal volume
Results in Hypercarbia, increased Carbon Dioxide levels in the blood stream
Trauma to the head/spinal cord factors affecting pulmonary ventilation
interrupts nervous control of ventilation
Results in decreased respiratory function and even failure.
Extrinsic Factors affecting pulmonary ventilation
blunt or penetrating trauma and burns
disrupts airflow through the trachea and into the lungs
Adequate Breathing for adults
12-20 breaths/min
Adequate Breathing for children
15-30 breaths/min
Adequate Breathing for infants
25-50 breaths/min
What factors create inaccurate pulse oximeter readings?
hypervolemia, anemia, severe peripheral vasoconstriction, nail polish, or dirty fingers.
What is OPA?
Inserted through the mouth of an unresponsive patient to keep the tongue from blocking the upper airway and to facilitate suctioning the airway
Complications of OPA?
vomiting, laryngospasm, injury to hard/soft palate, airway obstruction
What is NPA?
Inserted through the nostril of an patient who is unable to maintain airway patency independently
What are NPA indications?
conscious or semiconscious adults with or without gag reflex, Children older than 12 months of age, teeth are clenched and OPA cannot be inserted, Oral Trauma
What are NPA contraindications?
Infants less than 12 months, Severe head injury with blood draining from the nose, History or suspect of fractured nasal bone
What are NPA complications?
vomiting, laryngospasm, injury and pressure necrosis to nasal mucusa, laceration of adenoids or tissue lining to nasal cavity, severe nosebleed, airway obstruction if kinked or clogged
External Factors affecting respirations
decreased atmospheric pressure at high altitudes
Internal Factors affecting respirations
pneumonia, COPD, etc
What can compromise circulation?
trauma emegencies typically obstruct blood flow
Explain Adequate Breathing for adults
12-20 breaths per minute
regular inhalation/exhalation pattern
bilateral clear lungs
adequate breaths
chest rise and fall
Never suction the mouth or nose for more than __ seconds at one time for an adult
15
Never suction the mouth or nose for more than __ seconds at one time for a child
10
Never suction the mouth or nose for more than __ seconds at one time for an infant
5
Suctioning too long can result in
Hypoxia
What is the preferred way to give oxygen in the prehospital setting?
nonrebreathing mask; 10-15 L/min
What delivers oxygen through two small tubelike prongs?
nasal cannula
Nasal Cannula can provide ___ to ___% inspired oxygen when the flowmeter is set to 1-6 L/ min?
24% to 44%
The process by which carbon dioxide moves form a high concentration in the capillaries to a lower concentration in the alveoli is:
diffusion
The aspect of natural ventilation that involves the diaphragm contracting and the chest wall expanding is
inhalation
What does the upper airway consist of?
Pharynx, Mouth, Epiglottis, and Larynx
What does the lower airway consist of?
Trachea, Alveoli, Bronchioles, and Main Bronchi
The process by which carbon dioxide moves form a high concentration in the capillaries to a lower concentration in the alveoli is:
diffusion
A patient who is developing early stages of hypoxia may exhibit:
restlessness, irritability, apprehension, tachycardia, anxiety
A patient who takes an occasional gasping after his heart has stopped has ___ respirations
agonal
When inserting a nasopharyngeal airway, it is important to:
measure the size from the tip of the nose to the earlobe, ensure the bevel faces the septum when inserting into the right nare, and lubricating the airway with a water based lubrincant
If a D-sized oxygen cylinder contains 300 L of oxygen and is at 2,000 psi at the start of a call, the best estimate for the amount of time a patient can receive 15 L/min with a nonreabreathing mask is:
20 minutes
Properly performed suctioning of a patient may still cause
vomiting
When using a bag-valve mask device, what key finding should you observe to assure adequate ventilation?
good chest rise and fall
The most common complication of the flow restricted, oxygen-powered ventilation device is:
gastric distention
The structure also known as the windpipe is:
the trachea
Fresh air breathed into the lungs contains about what percentage of oxygen?
21%
Cells needs a constant supply of oxygen to suvive. Some cells may become severely or permanetley damaged after what period of time without oxygen?
4-6 minutes
With an oxygen rate of 15 L’min and an adequate mask to mouth seal, a bag-mas device with an oxygen reservoir can deliver what percentage of oxygen?
100%
What is ventilation?
physical act of breathing
What is Oxygenation?
Process of loading oxygen molecules onto hemoglobin molecules in blood stream
What is Respiration
actual exchange of oxygen and carbon dioxide in the alveoli as well as the tissue of the body
What is the partial pressure of oxygen in air residing in alveoli?
104 mmHg
A patient who is developing late stages of hypoxia may exhibit:
mental status changes, thready pulse, cyanosis
Fresh air breathed into the lungs contains about what percentage of nitrogen?
78%
Fresh air breathed into the lungs contains about what percentage of Carbon Dioxide?
0.3%
What is aerobic metabilism?
metabolism that can proceed only in th presence of oxygen
What is anaerobic metabolism?
the metabolism that takes place in the absence of oxygen
The is the product of anaerobic metabolism?
lactic acid
Describe chemoreceptors
monitor the levels of oxygen, carbon dioxide, hydrogen ions, and pH of the cerebrospinal fluid and then provides feedback to the respiratory centers to modify the rate and depth of breathing base on the body’s needs at any given time
Describe central chemoreceptors
located in the medulla, respond quickly to slight elevations in carbon dioxide, or decrease in the pH of cerebrospinal fluid
Describe peripheral chemoreceptors
located in the carotid arteries and aortic arch, are sensitive to decreased levels of oxygen in arterial blood as well as to low pH levels
Describe dorsal respiratory group
responsible for initiating inspiration based on the information received from the chemoreceptors
What does the apneustic center stimulate?
Dorsal respiratory group, resulting in slower, longer respirations
What is the ventral respiratory group’s primary responsibility?
motor control of the inspiratory and expiratory muscles
What does the pneumotaxic center help shut off?
the dorsal respiratory group, resulting in shorter, faster respirations
What is adequate breathing for adults?
12-20 breaths/min
What is adequate breathing for children?
15-30 breaths/min
What is adequate breathing for infants?
25-50 breaths/min
What can cause inacurate reading on the pulse oximeter?
hypervolemia, anemia, sever peripheral vasoconstriction, and nail polish/dirty fingers
What is OP airway?
inserted through the mouth of unresponsive patient to keep the tongue from blocking upper airway and facilitate suctioning
What is the indication for OP airway?
unresponsive with no gag reflex.
Apneic patient being ventilated with a bag-mask device
What is the contraindiction for OP airway?
conscious patient with gag reflex
What is NP airway?
inserted through the nostril of patient who is unable to maintain airway potency independently
What is indication for NP airway?
Semiconscious or unconscious with an intact gag reflex and will not tolerate the OP airway
What is contraindiction for NP airway?
severe head injury with blood drainage from the nose or history of fractured nasal bone
What is considered using accessory muscles?
sternocleidomastoid
What part of the airway serves as the functional site for gas exchange?
alveoli
As you approach the patient, he begins to should “Hurry up and take care of me, will you!” Early sings of hypoxia includes:
irritability
What supplemental oxygen device should you have your partner apply to a hypoxic patient?
nonrebreathing mask
Your patient tells you that he has a history of chronic obstructive pulmonary disease, diabetes mellitus, and high cholesterol. Patients with COPD are stimulated to breath by the
hypoxic drive
While en route to the emergency department, the patient’s level of coniousness diminshes, his respiratory rate decreased to 4 breaths/min his lips have a blue tint, and the pulse oximeter is not reading 65%. You should begin delivering artificial breaths with a bag-mask device at a rate of one breath every:
5-6 seconds
When ventilating a patient, the volume of air delivered to the patient is based on:
chest rise
Seizures and strokes are examples of what type of medical emergency?
neurologic
Your awareness and concern for potentially serious underlying and unseen injuries or illness is called the
index of suspicion
AEROBIC METABOLISM
METABOLISM THAT CAN PROCEED ONLY IN THE PRESENCE OF OXYGEN. (BI-PRODUCTS ARE WATER AND CARBON DIXOIDE)
AGONAL RESPIRATIONS
OCCASIONAL, GASPING BREATHS THAT OCCUR AFTER THE HEART HAS STOPPED.
AIRWAY
THE UPPER AIRWAY TRACT OR THE PASSAGE ABOVE THE LARYNX WHICH INCLUDES THE NOSE, MOUTH AND THROAT.
ALVEOLAR VENTILATION
THE VOLUME OF AIR THAT REACHES THE ALVEOLI. IT IS DETERMINED BY SUBTRACTING THE AMOUNT OF DEAD SPACE AIR FROM THE TIDAL VOLUME.
AMERICAN STANDARD SYSTEM
A SAFETY SYSTEM FOR LARGE OXYGEN CYLINDERS, DESIGNED TO PREVENT THE ACCIDENTAL ATTACHMENT OF A REGULATOR TO A CYLINDER CONTAINING THE WRONG TYPE OF GAS
ANAEROBIC METABOLISM
THE METABOLISM THAT TAKES PLACE IN THE ABSENCE OF OXYGEN. (BI-PRODUCT IS LACTIC ACID)
APNEA
ABSCENCE OF SPONTANEOUS BREATHING.
ASPIRATION
THE INTRODUCTION OF VOMITUS OR OTHER FOREIGN MATERIAL INTO THE LUNGS.
ATAXIC RESPIRATIONS
IRREGULAR, INEFFECTIVE RESPIRATIONS THAT MAY OR MAY NOT HAVE AN IDENTIFIABLE PATTERN.
AUTOMATIC TRANSPORT VENTILATOR (ATV)
A VENTILATION DEVICE ATTACHED TO A CONTROL BOX THAT ALLOWS THE VARIABLES OF VENTILATION TO BE SET. IT FRES THE EMT TO PERFORM OTHER TASKS WHILE THE PATIENT IS BEING VENTILATED.
BAG-MASK DEVICE
A DEVICE WITH A ONE-WAY VALVE AND A FACE MASK ATTACHED TO A VENTILATION BAG; WHEN ATTACHED TO A RESERVOIR AND CONNECTED TO OXYGEN, DELIVERS MORE THAN 90% SUPPLEMENTAL OXYGEN.
BARRIER DEVICE
A PROTECTIVE ITEM, SUCH AS A POCKET MASK WITH A VALVE, THAT LIMITES EXPOSURE TO A PATIENT’S BODY FLUIDS.
BILATERAL
A BODY PART OR CONDITION THAT APPEARS ON BOTH SIDES OF THE MIDLINE.
BRONCHIOLES
SUBDIVISION OF THE SMALLER BRONCHI IN THE LUNGS; MADE SMOOTH MUSCLE AND DILATE OR CONSTRICT IN RESPONSE TO VARIOUS STIMULI.
CARINA
POINT AT WHICH THE TRACHEA BIFURCATES (DIVIDES) INTO THE LEFT AND RIGHT MAINSTEM BRONCHI.
CHEMORECEPTORS
MONITOR THE LEVELS OF 02, C02 AND THE pH OF THE CEREBROSPINAL FLUID AND THEN PROVIDE FEEDBACK TO THE RESPIRATORY CENTERS TO MODIFY THE RATE AND DEPTH OF BREATHING BASED ON THE BODY’S NEEDS AT ANY GIVEN TIME.
COMPLIANCE
THE ABILITY OF THE ALVEOLI TO EXPAND WHEN AIR IS DRAWN IN DURING INHALATION.
CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP)
A METHOD OF VENTILATION USED PRIMARILY IN THE TREATMENT OF CRITICALLY ILL PATIENTS WITH RESPIRATORY DISTRESS; CAN PREVENT THE NEED FOR ENDOTRACHEAL INTUBATION.
CRICOID PRESSURE
PRESSURE ON THE CRICOID CARTILAGE; APPLIED TO OCCLUDE THE ESOPHAGUS TO INHIBIT GASTRIC DESTENTION AND REGURGITATION OF VOMITUS IN THE UNCONSCIOUS PATIENT.
DEAD SPACE
THE PORTION OF THE TIDAL VOLUME THAT DOES NOT REACH THE ALVEOLI AND THUS DOES NOT PARTICIPATE IN GAS EXCHANGE.
DIFFUSION
A PROCESS IN WHICH MOLECULES MOVE FROM AN AREA OF HIGHER CONCENTRATION TO AN AREA OF LOWER CONCENTRATION.
DYSPNEA
SHORTNESS OF BREATH
EXHALATION
THE PASSIVE PART OF THE BREATHING PROCESS IN WHICH THE DIAPHRAGM AND THE INTERCOSTAL MUSCLES RELAX, FORCING AIR OUT OF THE LUNGS.
EXTERNAL RESPIRATION
THE EXCHANGE OF GASES BETWEEN THE LUNGS AND THE BLOOD CELLS IN THE PULMONARY CAPILLARIES; ALSO CALLED PULMONARY RESPIRATION.
GAG REFLEX
A NORMAL REFLEX MECHANISM THAT CAUSES RETCHING; ACTIVATED BY TOUCHING THE SOFT PALATE OR THE BACK OF THE THROAT.
GASTRIC DISTENTION
A CONDITION IN WHICH AIR FILLS THE STOMACH, OFTEN AS A RESULT OF HIGH VOLUME AND PRESSURE DURING ARTIFICIAL VENTILATION.
GLOTTIS
THE SPACE IN BETWEEN THE VOCAL CORDS THAT IS THE NARROWEST PORTION OF THE ADULT’S AIRWAY, ALSO CALLED THE GLOTTIC OPENING.
GOOD AIR EXCHANGE
A TERM USED TO DISTINGUISH THE DEGREE OF DISTRESS IN A PATIENT WITH A MILD AIRWAY OBSTRUCTION. WITH GOD AIR EXCHANGE THE PATIENT IS STILL CONSCIOUS AND ABLE TO COUGH FORCEFULLY, ALTHOUGH WHEEZING MAY BE HEARD.
HEAD TILT-CHIN LIFT MANEUVER
A COMBINATION OF TWO MOVEMENTS TO OPEN THE AIRWA BY TILTING THE FOREHEAD BACK AND LIFTING THE CHIN; NOT USED FOR TRAUMA PATIENTS.
HYPERCARBIA
INCREASED CARBON DIOXIDE LEVEL IN THE BLOODSTREAM.
HYPOXIA
A DANGEROUS CONDITION IN WHICH THE BODY TISSUES AND CELLS DO NOT HAVE ENOUGH OXYGEN.
HYPOXIC DRIVE
A CONDITION IN WHICH CHRONICALLY LOW LEVELS OF OXYGEN IN THE BLOOD STIMULATE THE RESPIRATORY DRIVE, SEEN IN PATIENTS WITH CHRONIC LUNG DISEASES.
INHALATION
THE ACTIVE, MUSCULAR PART OF BREATHING THAT DRAWS AIR INTO THE AIRWAY AND LUNGS.
INTERNAL RESPIRATION
THE EXCHANGE OF GASES BETWEEN THE BLOOD CELLS AND THE TISSUES.
INTRAPULMONARY SHUNTING
BYPASSING OF OXYGEN POOR BLOOD PAST NONFUNCTIONAL ALVEOLI TO THE LEFT SIDE OF THE HEART.
JAW-THRUST
TECHNIQUE TO OPEN THE AIRWAY BY PLACING THE FINGERS BEHIND THE ANGLE OF THE JAW AND BRINING THE JAW FORWARD; USED FOR PATIENTS WHO MAY HAVE A CERVICAL SPINE INJURY.
LABORED BREATHING
BREATHING THAT REQUIRES GREATER THAN NORMAL EFFORT; MAY BE SLOWER OR FASTER THAN NORMAL AND USUALLY REQUIRES THE USE OF ACCESSORY MUSCLES.
LARYNX
A COMPLEX STRUCTURE FORMED BY MANY INDEPENDENT CARTILAGINOUS STRUCTURES THAT ALL WORK TOGETHER; WHERE THE UPPER AIRWAY ENDS AND THE LOWER AIRWAY BEGINS; ALSO CALLED THE VOICE BOX.
MANUALLY TRIGGERED VENTILATION DEVICE
A FIXED FLOW/RATE VENTILATION DEVICE THAT DELIVERS A BREATH EVERYTIME ITS BUTTON IS PUSHED; ALSO REFERRED TO AS A FLOW-RESTICTED, OXYGEN POWERED VENTILATION DEVICE.
MEDIASTINUM
SPACE WITHIN THE CHEST THAT CONTAINS THE HEART, MAJOR BLOOD VESSELS, VAGUS NERVE, TRACHEA, MAJOR BRONCHI AND ESOPHAGUS; LOCATED BETWEEN THE TWO LUNGS.
METABOLISM (CELLULAR RESPIRATION)
THE BIOCHEMICAL PROCESSES THAT RESULT IN PRODUCTION OF ENERGY FROM NUTRIENTS WITHIN THE CELLS.
MILD AIRWAY OBSTRUCTION
OCCURS WHENA FOREIGN BODY PARTIALLY OBSTRUCTS THE PATIENT’S AIRWAY. THE PATIENT IS ABLE TO MOVE ADEQUATE AMOUNTS OF AIR, BUT ALSO EXPERIENCES SOME DEGREE OF RESPIRATORY DISTRESS.
MINUTE VENTILATION
THE VOLUME OF AIR MOVED THROUGH THE LUNGS IN 1 MINUTE MINUS THE DEAD SPACE; CALCULATED BY MULTIPLYING TIDAL VOLUME (MINUS DEAD SPACE) AND RESPIRATORY RATE; ALSO REFERRED TO AS MINUTE VOLUME.
NASAL CANNULA
AN OXYGEN DELIVERY DEVICE IN WHICH THE OXYGEN FLOWS THROUGH TWO SMALL, TUBELIKE PRNOGS THAT FIT INTO THE PATIENT’S NOSTRILS; DELIVERS 24%-44% SUPPLEMENTAL OXYGEN, DEPENDING ON THE FLOW RATE.
NASOPHARYNGEAL (NASAL) AIRWAY
AIRWAY ADJUNCT INSERTED INTO THE NOSTRIL OF AN UNRESPONSIVE PATIENT, OR A PATIENT WITH AN ALTERED LEVEL OF CONSCIOUSNESS WHO IS UNABLE TO MAINTAIN AIRWAY PATENCY INDEPENDENTLY.
NASOPHARYNX
THE NASAL CAVITY; FORMED BY THE UNION OF FACIAL BONES AND PROTECTS THE RESPIRATORY TRACT FROM CONTAMINANTS.
NONREBREATHING MASK
A COMBINATION MASK AND RESERVOIR BAG SYSTEM THAT IS THE PREFERRED WAY TO GIVE OXYGEN IN THE PREHOSPITAL SETTING; DELIVERS UP TO 90% INSPIRED OXYGEN AND PREVENTS INHALING THE EXHALED GASES (CARBON DIXOIDE)
OROPHARYNGEAL (ORAL) AIRWAY
AIRWAY ADJUNCT INSERTED INTO THE MOUTH OF AN UNRESPONSIVE PATIENT TO KEEP THE TOUNGE FROM BLOCKING THE UPPER AIRWAY AND TO FACILITATE SUCTIONING THE AIRWAY IF NECESSARY.
OROPHARYNX
FORMS THE POSTERIOR PORTION OF THE ORGAL CAVITY, WHICH IS BORDERED SUPERIORLY BY THE HARD AND OFT PALATES, LATERALLY BY THE CHEEKS, AND INFERIORLY BY THE TOUNGE.
OXYGENATION
THE PROCESS OF DELIVERING OXYGEN TO THE BLOOD BY DIFFUSION FROM THE ALVEOLI FOLLOWING INHALATION INTO THE LUNGS.
PARIETAL PLEURA
THIN MEMBRANE THAT LINES THE CHEST CAVITY.
PARTIAL PRESSURE
THE TERM USED TO DESCRIBE THE AMOUNT OF GAS IN AIR OR DISSOLVED IN FLUID, SUCH AS BLOOD.
PATENT
OPEN CLEAR OF OBSTRUCTION
PHRENIC NERVE
NERVE THAT INNERVATES THE DIAPHRAGM; NECESSARY FOR ADEQUATE BREATHING TO OCCUR.
PIN-INDEXING SYSTEM
A SYSTEM ESTABLISHED FOR PORTABLE CYLINDERS TO ENSURE THAT A REGULATOR IS NOT CONNECTED TO A CYLINDER CONTAINING THE WRONG TYPE OF GAS.
PNEUMOTHORAX
A PARTIAL OR COMPLETE ACCUMULATION OF AIR IN THE PLEURAL SPACE.
POOR AIR EXCHANGE
A TERM USED TO DESCRIBE THE DEGREE OF DISTRESS IN A PATIENT WITH A MILD AIRWAY OBSTRUCTION. WITH POOR AIR EXCHANGE, THE PATIENT OFTEN HAS A WEAK, INEFFECTIVE COUGH, INCREASED DIFFICULTY BREATHING, OR POSSIBLE CYANOSIS AND MAY PRODCE A HIGH-PITCHED NOISE DURING INHALATION (STRIDOR)
POSITIVE END-EXPIRATORY PRESSURE (PEEP)
MECHANICAL MAINTENANCE O PRESURE IN THE AIRWAY AT THE END OF EXPIRATION TO INCREASE THE VOLUME OF GAS REMAINING IN THE LUNGS.
PULSE OXIMETRY
AN ASSESSMENT TOOL THAT MEASURES OXYGEN SATURATION OF HEMOGLOBIN IN THE CAPILLARY BEDS.
RECOVERY POSITION
A SIDE-LYING POSITION USED TO MAINTAIN A CLEAR AIRWAY IN UNCONSCIOUS PATIENTS WITHOUT INJURIES WHO AE BREATHING ADEQUATELY.
RESIDUAL VOLUME
THE AIR THAT REMAINS IN THE LUNGS AFTER MAXIMAL EXPIRATION.
RESPIRATION
THE PROCESS OF EXCHANGING OXYGEN AND CARBON DIOXIDE.
RETRACTIONS
MOVEMENTS IN WHICH THE SKIN PULLS IN AROUND THE RIBS DURING INSPIRATION.
SELLICK MANEUVER
A TECHNIQUE THAT IS USED TO PREVENT GASTRIC DISTENTION IN WHICH PRESSURE IS APPLIED TO THE CRICOID CARTILAGE; ALSO REFERRED TO AS CRICOID PRESSURE.
SEVER AIRWAY OBSTRUCTION
OCCURS WHEN A FOREIGN BODY COMPLETELY OBSTRUCTS THE PATIENT’S AIRWAY. PATIENT’S CANNOT BREATHE, TALK OR COUGH.
STOMA
AN OPENING THROUGH THE SKIN AND INTO AN ORGAN OR OTHER STRUCTURE; A STOMA IN THE NECK CONNECTS THE TRACHEA DIRECTLY TO THE SKIN.
STRIDOR
A HIGH-PITCHED NOISE HEARD PRIMARILY ON INSPIRATION.
SUCTION CATHETER
A HOLLOW, CYLINDRICAL DEVICE USED TO REMOVE FLUID FROM THE PATIENT’S AIRWAY.
SURFACTANT
A LIQUID PROTEIN SUBSTANCE THAT COATS THE ALVEOLI IN THE LUNGS, DECREASES ALVEOLAR SURFACE TENSION, AND KEEPS THE ALVEOLI EXPANDED; A LOW LEVEL IN A PREMATURE INFANT CONTRIBUTES TO RESPIRATORY DISTRESS SYNDROME.
TENSION PNEUMOTHORAX
A LIFE-THREANING COLLECTION OF AIR WITHIN THE PLEURAL SPACE; THE VOLUME AND PRESSURE HAVE BOTH COLLAPSED THE INVOLVED LUNG AND CAUSED A SHIFT OF THE MEDIASTINAL STRUCTURES TO THE OPPOSITE SIDE.
TIDAL VOLUME
THE AMOUNT OF AIR (IN mL) THAT IS MOVED IN OR OUT OF THE LUNGS DURING ONE BREATH.
TONSIL TIPS
LARGE, SEMIRIGID SUCTION TIPS RECOMMENDED FOR SUCTIONING THE PHARYNX; ALSO CALLED YANKAUER TIPS.
TRACHEOSTOMY
SURGICAL OPENING INTO THE TRACHEA.
VENTILATION
EXCHANGE OF AIR BETWEEN THE LUNGS AND THE ENVIRONMENT, SPONTANEOUSLY BY THE PATIENT OR WITH ASSISTANCE FROM ANOTHER PERSON, SUCH AS AN EMT.
VISCERAL PLEURA
THIN MEMBRANE THAT COVERS THE LUNGS
VITAL CAPACITY
THE AMOUNT OF AIR THAT CAN BE FORCIBLY EXPELLED FROM THE LUNGS AFTER BREATHING IN AS DEEPLY AS POSSIBLE.
VOCAL CORDS
THIN WHITE BANDS OF TOUGH MUSCULAR TISSUE THAT ARE LATERAL BORDERS OF THE GLOTTIS AND SERVE AS THE PRIMARY CENTER FOR SPEECH PRODUCTION.
WHEEZING
THE PRODUCTION OF WHISTLING SOUNDS DURING EXPIRATION SUCH AS OCCURS IN ASTHMA AND BRONCHIOLITIS.
Appropriate suctioning setting for adult
between 80-120 mmHg
Appropriate suctioning setting for children
between 50-100 mmHg
How to measure catheter insertion for OP?
corner of mouth to edge of earlobe
What will occur with excessive negative pressure from OP suctioning?
hypoxia
When should oxygen be removed?
when suctioning is ready
Maximum suctioning time for Peds
5-10 seconds
Maximum suctioning time for adults
10-15 seconds
Rigid Catheter oxygen sourse ventilation rate for Adults
10-20/minute
Rigid Catheter oxygen source ventilation rate for Peds
12-20/minute
You are dispatched to the county jail for an inmate who is “sick.” When you arrive, you find the patient, a 33-year-old male, unresponsive. His airway is patent and his respirations are rapid and shallow. Your initial action should be to:

A) provide assisted ventilation.
B) assess his blood pressure.
C) request a paramedic unit.
D) apply a pulse oximeter.

A) provide assisted ventilation.
A 40-year-old male crashed his motorcycle into a tree. He is semiconscious, has snoring respirations, and has a laceration to the forearm with minimal bleeding. You should:

A) tilt the patient’s head back and lift up on his chin.
B) apply a cervical collar and suction his airway.
C) open his airway with the jaw-thrust maneuver.
D) apply a pressure dressing to the patient’s arm.

C) open his airway with the jaw-thrust maneuver.
You and your partner are caring for a critically injured patient. Your partner is controlling severe bleeding from the patient’s lower extremities as you attempt ventilations with a bag-mask device. After repositioning the mask several times, you are unable to effectively ventilate the patient. You should:

A) hyperextend the patient’s head and reattempt ventilations.
B) suction the patient’s airway for 30 seconds and reattempt ventilations.
C) continue attempted ventilations and transport immediately.
D) begin ventilations using the mouth-to-mask technique.

D) begin ventilations using the mouth-to-mask technique.
The jaw-thrust maneuver is used to open the airway of patients with suspected:

A) mandibular fractures.
B) upper airway swelling.
C) cervical spine injuries.
D) copious oral secretions.

C) cervical spine injuries.
The hypoxic drive—the primary stimulus to breathe for patients with certain chronic respiratory diseases— is influenced by:

A) high blood oxygen levels.
B) low blood oxygen levels.
C) low blood carbon dioxide levels. D) high blood carbon dioxide levels.

B) low blood oxygen levels.
The nasopharyngeal airway is MOST beneficial because it:

A) can effectively stabilize fractured nasal bones if it is inserted properly.
B) effectively maintains the airway of a patient in cardiopulmonary arrest.
C) is generally well tolerated in conscious patients with an intact gag reflex.
D) can maintain a patent airway in a semiconscious patient with a gag reflex.

D) can maintain a patent airway in a semiconscious patient with a gag reflex.
One of the primary waste products of normal cellular metabolism that must be removed from the body by the lungs is:

A) carbon dioxide.
B) carbon monoxide.
C) pyruvic acid.
D) lactic acid.

A) carbon dioxide.
A 37-year-old male was pinned between a flatbed truck and a loading dock. On exam, you find bruising to the chest, distended neck veins, bilaterally diminished breath sounds, and bilateral scleral hemorrhaging. You should:
.
aggressively manage his airway.
A 30-year-old female was robbed and assaulted by a gang as she was leaving a nightclub. She has massive facial trauma and slow, gurgling respirations. As your partner manually stabilizes her head, you should:
suction her oropharynx for 15 seconds.
You are transporting a 42-year-old male who experienced blunt abdominal trauma. He is receiving oxygen at 12 L/min via a nonrebreathing mask, and full spinal precautions have been applied. During your reassessment, you note his level of consciousness has decreased and his respirations have become shallow. You should:
insert an airway adjunct if he will tolerate it and begin assisting his ventilations with a bag-mask device.

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