Airway and Breathing Flashcards

You arrive at the scene of an elderly woman who has fallen and injured her ribs. She is breathing very rapidly at a rate of 40 and shallow. How is this a serious life threat?

Answer: Her minute volume may be diminished

Minute volume is the total amount of air moved in and out of the lungs per minute (respiratory rate x tidal volume). Rapid, shallow breathing, even at a high rate, often results in a significantly reduced tidal volume, meaning less air reaches the alveoli for gas exchange. This leads to a diminished minute volume and inadequate ventilation, which is a serious life threat.

The endotracheal tube is primarily intended to:

Answer: Be inserted into the trachea

The primary purpose of an endotracheal tube (ET tube) is to establish a secure and patent airway by being inserted directly into the trachea. This allows for direct ventilation of the lungs, protection against aspiration, and efficient delivery of oxygen and medications (though medication delivery is a secondary use). It is crucial that it is placed in the trachea and not the esophagus.

The Sellick's maneuver is designed to:

Answer: Reduce the risk of vomiting

The Sellick's maneuver, also known as cricoid pressure, involves applying firm pressure to the cricoid cartilage. This maneuver is intended to compress the esophagus against the cervical vertebrae, thereby reducing the risk of gastric insufflation and regurgitation of stomach contents into the airway during positive pressure ventilation or intubation.

After placing an endotracheal tube and performing an auscultation, you notice lung sounds on the right are present, but lung sounds on the left are absent or diminished. What should you do?

Answer: Deflate the cuff and back the Endotracheal tube out 3-4 cm

Absent or diminished lung sounds on one side, especially the left, after intubation often indicates a right mainstem bronchus intubation. The ET tube has advanced too far, entering the right main bronchus and blocking airflow to the left lung. To correct this, the cuff should be deflated, and the tube gently withdrawn 3-4 cm, then the cuff reinflated and lung sounds rechecked.

Medical control has ordered you to assist a patient with a metered dose inhaler. Before assisting this patient, you must ensure what

Answer: It is their medication and is within the expiration date

Before assisting a patient with their metered dose inhaler, it is crucial to confirm that it is indeed the patient's prescribed medication and that it has not expired. Administering the wrong medication or an expired one can be ineffective or harmful. While other factors are important, medication verification is a fundamental safety step.

A spontaneous pneumothorax is ?

Answer: A sudden accumulation of air in the pleural space

A spontaneous pneumothorax is a sudden and unexpected accumulation of air in the pleural space, the area between the lung and the chest wall. This air causes the lung to collapse, leading to shortness of breath and chest pain. It often occurs without any preceding trauma and is more common in tall, thin males or individuals with underlying lung conditions.

An intervention for someone who is apneic would be?

Answer: All of the above

Apnea refers to the cessation of breathing. For a patient who is apneic, immediate interventions are required to restore ventilation and oxygenation. An oropharyngeal airway (OPA) or nasopharyngeal airway (NPA) can help maintain an open airway, a Bag-Valve-Mask (BVM) is used for positive pressure ventilation, and intubation provides a definitive airway. Therefore, all these interventions are appropriate depending on the situation and provider skill level.

Paradoxical motion of the chest during exhalation is often caused by what type of injury?

Answer: Flail Chest

Paradoxical motion of the chest, where a segment of the chest wall moves inward during inhalation and outward during exhalation, is a classic sign of a flail chest. This injury occurs when three or more adjacent ribs are fractured in two or more places, creating a free-floating segment that moves independently of the rest of the chest wall. This significantly impairs effective ventilation.

Cardiac arrest in children is most often caused by:

Answer: Respiratory compromise.

In children, cardiac arrest is most frequently a secondary event caused by progressive respiratory compromise or shock that leads to hypoxia and acidosis. Unlike adults, where primary cardiac events are more common, children's hearts are generally healthy and fail due to prolonged lack of oxygen. Addressing respiratory issues early is critical in pediatric care.

The first step in artificial ventilation with a bagvalve-mask unit in patients with no suspected trauma is to:

Answer: Place the patient’s head in a hyperextended, sniffing position.

For patients with no suspected trauma, the head-tilt/chin-lift maneuver is the initial and most effective way to open the airway. This maneuver lifts the tongue off the posterior pharynx, which is the most common cause of airway obstruction in an unconscious patient. Once the airway is open, an airway adjunct can be inserted, and the mask positioned.

A 70-year-old patient is complaining of shortness of breath. She has a history of emphysema. You should:

Answer: Administer oxygen, because in most cases, the hypoxic drive will not be a problem.

While patients with emphysema (a form of COPD) may rely on a 'hypoxic drive' to breathe, withholding oxygen is generally not recommended in acute respiratory distress. The risk of eliminating the hypoxic drive is often overstated, and the immediate need for oxygen to prevent hypoxia and organ damage outweighs this theoretical risk. Administering oxygen, while monitoring the patient, is the correct approach.

A danger of using a rigid suction catheter with infants and young children is that stimulating the back of the throat can:

Answer: Cause changes in the heart rhythm.

Stimulating the back of the throat, particularly with a rigid suction catheter, can trigger the vagal nerve. In infants and young children, vagal stimulation can lead to a reflex bradycardia (slowing of the heart rate) and other changes in heart rhythm, which can be dangerous. Therefore, caution and careful technique are essential when suctioning pediatric patients.

Your patient is a 35-year-old trauma victim who is not breathing. You are unable to open the airway by means of the jaw thrust and suctioning. You should:

Answer: Use the head-tilt/chin-lift technique.

If the jaw-thrust maneuver and suctioning fail to open the airway in a trauma victim, and there is still no suspected spinal injury (or if the benefits of opening the airway outweigh the risks), the head-tilt/chin-lift technique may be attempted as a secondary measure. This maneuver is more effective at opening the airway than jaw thrust alone, but should be used with caution in trauma.

Which statement about inadequate breathing is correct?

Answer: A breathing rate that is either too fast or too slow may indicate inadequate breathing.

Inadequate breathing is characterized by a respiratory rate that is either too fast (tachypnea) or too slow (bradypnea), or breathing that is too shallow or too deep. Both extremes can compromise the body's ability to effectively exchange oxygen and carbon dioxide, leading to hypoxia or hypercapnia. Normal breathing is regular, effortless, and within an appropriate rate and depth.

What is the structure that prevents food and liquid from entering the trachea during swallowing?

Answer: Epiglottis

The epiglottis is a leaf-shaped flap of cartilage located at the base of the tongue. Its crucial function is to cover the opening of the trachea (windpipe) during swallowing, preventing food and liquids from entering the respiratory tract and directing them into the esophagus instead. This protective mechanism is vital to prevent aspiration.