Airways 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). While the patient is breathing rapidly, her shallow breaths indicate a very low tidal volume. This combination significantly reduces the effective minute volume, leading to inadequate gas exchange and potential hypoxia, making it a serious life threat.

The endotracheal tube is primarily intended to:

Answer: Be inserted into the trachea

The primary purpose of an endotracheal tube is to establish a secure and definitive airway. It is specifically designed to be inserted directly into the trachea, bypassing the upper airway, to allow for direct ventilation and oxygenation of the lungs. This placement ensures an unobstructed path for air and protects the airway from aspiration.

The Sellick's maneuver is designed to:

Answer: Reduce the risk of vomiting

The Sellick's maneuver, or cricoid pressure, involves applying firm pressure to the cricoid cartilage. This action compresses the esophagus against the cervical vertebrae, thereby occluding it. The main goal is to prevent gastric regurgitation and subsequent aspiration of stomach contents into the lungs during intubation, especially in patients at risk for vomiting.

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

Unilateral lung sounds (present on one side, absent/diminished on the other) after endotracheal intubation typically indicate a right mainstem bronchus intubation, meaning the tube has advanced too far into the right lung. To correct this, the cuff should be deflated to prevent tracheal trauma, and the tube gently withdrawn a few centimeters until bilateral lung sounds are heard, then the cuff reinflated.

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 any medication, it is crucial to confirm the 'five rights' of medication administration. Ensuring it is the patient's prescribed medication and has not expired prevents administering the wrong drug or an ineffective one. This step is essential for patient safety and therapeutic efficacy.

A spontaneous pneumothorax is ?

Answer: A sudden accumulation of air in the pleural space

A spontaneous pneumothorax occurs when air leaks into the pleural space (the area between the lung and chest wall) without any external trauma. This sudden accumulation of air causes the lung to collapse, leading to symptoms like shortness of breath and chest pain. It is often caused by the rupture of small air sacs (blebs) on the lung surface.

An intervention for someone who is apneic would be?

Answer: All of the above

Apnea means the patient is not breathing. All listed interventions—oropharyngeal airway, BVM mask, and intubation—are appropriate methods to assist or control a patient's breathing and ensure an open airway. Therefore, any or all of these can be used to manage an apneic patient, depending on the specific 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 is the hallmark sign of a flail chest, which occurs when three or more adjacent ribs are fractured in two or more places. This creates a segment of the chest wall that moves independently of the rest of the rib cage. During exhalation, the flail segment bulges out, opposite to the normal chest wall movement.

Cardiac arrest in children is most often caused by:

Answer: Respiratory compromise.

In children, cardiac arrest is most commonly secondary to respiratory failure or shock, rather than a primary cardiac event. Their hearts are generally healthy, but prolonged hypoxia or inadequate ventilation leads to bradycardia, which then progresses to asystole. Addressing respiratory issues early is critical in pediatric resuscitation to prevent cardiac arrest.

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 initial step to open the airway is the head-tilt/chin-lift maneuver. This involves placing the patient's head in a hyperextended, sniffing position. This maneuver lifts the tongue off the posterior pharynx, clearing the most common obstruction to airflow, before proceeding with mask placement or ventilation.

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 some patients with severe COPD may rely on a hypoxic drive, withholding oxygen in an acute emergency due to this concern is generally not recommended. Hypoxia is an immediate and life-threatening problem that requires oxygen administration. The risk of eliminating the hypoxic drive is often overstated in acute settings, and oxygen is usually safe and necessary to improve oxygenation.

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 posterior pharynx, especially with a rigid suction catheter, can trigger a vagal response. In infants and young children, whose vagal tone is more pronounced, this can lead to bradycardia (slowing of the heart rate) or even asystole. Therefore, suctioning in pediatric patients must be performed carefully and for limited durations to avoid adverse cardiac effects.

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.

The jaw-thrust maneuver is the preferred method for opening the airway in trauma patients due to the potential for spinal injury. However, if the jaw-thrust is unsuccessful in opening the airway, the head-tilt/chin-lift maneuver should be attempted as a secondary measure. Maintaining an open airway and ensuring ventilation takes precedence over the theoretical risk of spinal injury if the initial method fails.

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 falls outside the normal range, either too fast or too slow, or by insufficient tidal volume. Both extremes in rate can compromise gas exchange, leading to hypoxia or hypercapnia. Therefore, an abnormal breathing rate is a key indicator of inadequate breathing.

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. During swallowing, it folds down to cover the opening of the larynx (glottis), preventing food and liquid from entering the trachea and lungs. This protective mechanism ensures that ingested material goes into the esophagus, preventing aspiration.