EMT/NREMT (Airway Practice Test)

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What is a nasal cannula's maximum flow rate?

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A nasal cannula used to administer O2 at flow rates from 2 - 6 LPM, delivering an O2 concentration so 28 - 44%

A device that makes blind intubation of a patient easier. A cuffed double-lumen tube with one blind end makes up this device. When the cuff is inflated, the device acts as an endotracheal tube, closing off the esophagus and permitting ventilation while avoiding gastric reflux.

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This device is also known as a Combi-Tube

What should the flow rate be to provide "100%" Oxygen Therapy?

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12-15 LPM administered via a NBR or Non Rebreather mask is considered "100% O2"

What airway opening maneuver should you use on a man who has fallen off a ladder and is having trouble breathing?

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The "Jaw Thrust" maneuver should be used to open the airway of any patient who has suffered a traumatic injury

A ____________ is a device that delivers a specified amount of medication to the lungs in the form of a short burst of aerosolized medicine that the patient inhales.

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A Metered Dose Inhaler is commonly used to treat Asthma, Chronic Obstructive Pulmonary Disease, and other respiratory problems.

The upper and lower airways compose the anatomy of the airway. The mouth and Nares are where the upper airway begins, and it ends at the?

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The airway is divided into two different anatomical locations; the upper airway and lower airway. The upper airway starts where air enters the body - the nose (Nares) and the mouth. Air will pass through the nose and is filtered and warmed before passing through the remainder of the upper airway and entering the lower airway. The upper airway ends at the Cricoid cartilage, the distal end of the larynx. The Thyroid cartilage is located at the proximal end of the larynx. Reference: Jeremy P. T. Ward; Jane Ward; Charles M. Wiener (2006). The respiratory system at a glance. Wiley-Blackwell. pp. 11–. ISBN 978-1-4051-3448-4. Retrieved 26 April 2010.

The tongue often obstructs the airway by falling back and occluding the?

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The pharynx or throat is often occluded by the tongue falling back and obstructing air flow. When air enters the nostrils it passes through the nasopharynx, then the oropharynx, and then the pharynx before it enters the trachea. Jaw thrust or chin lift will pull the tongue off the back of the pharynx to open the airway allowing air flow to the lungs. The trachea is too distal for the tongue to occlude it.

At the Alveoli, where gas exchange takes place, the lower airway comes to an end. By passing across a semipermeable membrane, oxygen passes to hemoglobin. Where did this happen?

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Within each air sac, the oxygen concentration is high, so oxygen passes or diffuses across the alveolar membrane into the pulmonary capillary. At the beginning of the pulmonary capillary, the hemoglobin in the red blood cells has carbon dioxide bound to it and very little oxygen. The oxygen binds to hemoglobin and the carbon dioxide is released. Carbon dioxide is also released from sodium bicarbonate dissolved in the blood of the pulmonary capillary. The concentration of carbon dioxide is high in the pulmonary capillary, so carbon dioxide leaves the blood and passes across the alveolar membrane into the air sac. This exchange of gases occurs rapidly (fractions of a second). The carbon dioxide then leaves the alveolus when you exhale and the oxygen-enriched blood returns to the heart. Thus, the purpose of breathing is to keep the oxygen concentration high and the carbon dioxide concentration low in the alveoli so this gas exchange can occur! Source:http://science.howstuffworks.com/environmental/life/human-biology/lung2.htm

The diaphragm contracts and moves ___________ to create negative pressure in the thorax (chest cavity). This extends the thorax's volume, allowing air to rush into the lungs.

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The diaphragm is a thin tough muscle which separates the thorax and abdomen. The diaphragm is domed upward in its relaxed state, so when it contracts the diaphragm flattens out causing the volume of the thorax to increase. Since the pressure in the thorax is lower than atmospheric pressure, air will rush into the lungs and allow gas exchange. While the chest wall does expand, the diaphragm is the primary respiratory muscle. Chest muscles have a smaller role in regard to normal respiration.

The diaphragm regains its domed shape when it relaxes. The thoracic pressure rises as a result of this movement, forcing air out of the lungs. The _________ pressure in the thorax must rise above the pressure to force air out of the lungs.

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For air to be pushed out of the lungs, the trans thoracic pressure must rise above atmospheric (barometric) pressure. The diaphragm will relax and dome upward and the intercostal muscles will contract and pull the rib cage inward. This action increases the trans thoracic pressure above atmospheric pressure which forces air out.

Which of the following techniques is most likely to result in the LOWEST tidal volumes?

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With both mouth-to-mouth and mouth-to-mask ventilation, it is relatively easy to maintain a good seal with the patient's mouth, allowing for delivery of adequate tidal volumes. Likewise, two person bag-valve-mask techniques dedicate one rescuer solely to ensuring adequate mask seal and the second rescuer to squeeze the ventilation bag with two hands (again allowing for adequate tidal volumes to be delivered). One person bag-valve-mask usage is a difficult technique to master, as the single rescuer must maintain a manual airway maneuver, an adequate mask seal, and squeeze the bag simultaneously.

A paramedic may use Sellick's maneuver to help with intubation. Which cartilage are you compressing during this procedure?

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While all of theses structures are in the same general area, the paramedic specifically utilizes the Cricoid cartilage. This is particularly important since this is the only "full ring" cartilage.

You are transporting an elderly male patient in respiratory distress with a history of COPD... With minimal chest wall motion and slight wheezing in the upper lung fields, the patient's breathing is shallow and rapid. What do you think the arterial carbon dioxide levels would be in this situation?

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The patient would be hypercapnic as he is probably only ventilating dead space. The patient is not breathing deep enough for air exchange to occur in the alveoli, hence the elevated levels of carbon dioxide.

You are transporting a 48-year-old male patient between medical facilities... During the history, you learn that the patient fell at work and had a hip fracture as well as a head injury. The patient now has difficult breathing at 30 minutes per minute, a heart rate of 104, and a blood pressure of 98/70, which has gotten worse during the last 24 hours. Diffuse rales can be heard on auscultation. Beyond the pain from his recent fall, the patient denies any other symptoms of pain. What's the most likely reason for the patient's respiratory distress?

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Adult respiratory distress syndrome involves non-cardiogenic pulmonary edema that presents 12-72 hours post injury or surgery. Congestive heart failure and cardiogenic shock, while they may occur from the ARDS, have an initial cardiac compromise. Flash pulmonary edema has a rapid onset and deterioration over as little as 30 minutes and is associated with renal dysfunction.

Which of the following methods for giving ventilations to an apneic patient is the most effective?

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The two person bag-valve-mask is the most effective method to administer ventilations with a BVM; however, it is not always practical for field application due to limited resources and limited space. The use of mouth to mask ventilations is also identified as a viable form of artificial ventilations, but the risk of cross contamination in mouth to mouth ventilations renders it less desirable to health care providers.

What do you call the blue or greyish skin tone caused by a lack of oxygen in the blood?

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Cyanosis occurs when the oxygen saturation of arterial blood falls below 85-90%. It is often presented in the lips and nail beds first.

You're performing rescue breaths using an Ambu bag filled with 100% oxygen. After a few breaths, you'll notice that the patient's oxygen saturation has dropped. What do you think you should do next?

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This is a sign that you are not getting effective respirations. You should reposition the patient's head using the head tilt/chin lift or jaw thrust maneuver and attempt respirations again.

What is the appropriate amount of air to inject into an Endo Tracheal Tube's cuff?

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The standard ET Tube cuff is inflated with 10 cc of air

What do you call the space between the base of the tongue and the epiglottis?

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The Vallecula is an important landmark in intubation; it is where the blade of a laryngoscope is placed to facilitate direct visualization of the glottis.

Gasping, difficult breathing and strange vocalizations are all symptoms of what condition?

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Agonal respirations are also commonly seen in cases of cardiac arrest and may persist for several minutes after cessation of heartbeat.

When attempting intubation, what is the maximum length of time that may pass?

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If you are unsuccessful with your intubation, you should always cease your attempt after 30 seconds, allow for the patient to be hyperventilate, and attempt it again.

A high-pitched sound caused by turbulent airflow in the upper airway is a sign of what condition? It might be inspiratory, expiratory, or both inspiratory and expiratory.

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Stridor is indicative of severe upper airway obstruction.

These two big tubes that carry air to and from the lungs are known as?

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The Trachea leads to the Bronchi which leads into the Bronchioles.

Which of the following is NOT an indication of adequate breathing?

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Using abdominal muscles to breathe is a sign of labored breathing NOT adequate breathing.

A patient with shortness of breath is usually treated with which medicine opens the bronchioles and increases breathing efficiency?

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Bronchodilators are used to dilate or widen the bronchioles allowing air to more easily flow through them. A common bronchodilator is Albuterol.

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