NREMT P-medic: Airway Exam
Questions & Answers (Grade A+)
After determining that your unresponsive patient has a severe
(complete) upper airway obstruction caused by a foreign body, you
should: -
correct answer ✅Perform chest compressions.
Once you have determined that your unresponsive patient has a
severe FBAO you should perform 30 chest compressions, open the
airway and visualize the mouth, and remove the foreign body only
if you can see it. Heimlich maneuver is indicated for responsive
adults and children with a severe FBAO.
A 16-year-old male presents with acute respiratory distress. His
mother tells you that he recently lost his job. He is conscious and
alert, but obviously anxious. He has a respiratory rate of 40
breaths/min and an oxygen saturation of 98% on room air. Further
assessment reveals carpopedal spasms to his hands. Initial
management for this patient should include: -
correct answer ✅Providing coaching to slow the patient's
breathing.
On the basis of the patient HX and physical findings, this case is
consistent with an anxiety attack and hyperventilation syndrome.
These patients initially need emotional support and respiratory
coaching. If the patient's respirations do not slow down after a
,NREMT P-medic: Airway Exam
Questions & Answers (Grade A+)
reasonable period of coaching, you should consider the presence of
another underlying cause, such as hypoxemia, and administer high-
flow oxygen. The causes of hyperventilation are many; acute
anxiety is but one of them. If you are able to successfully control
the patient's breathing, yet he is still experiencing anxiety, it would
not be unreasonable to administer a sedative drug, such as Valium,
provided that his vital signs are stable and his breathing remains
adequate.
A 56-year-old male presents with respiratory distress. He appears
tired and is slow to answer your questions. He is taking a series of
quick breaths, followed by prolonged exhalation. On the basis of
these clinical findings, you should: -
correct answer ✅Provide some form of positive-pressure
ventilation.
Your patient is not breathing adequately. His tired appearance and
delay in answering your questions are signs of decreased cerebral
perfusion secondary to inadequate ventilation. You must restore his
tidal volume by providing some form of positive-pressure
ventilatory assistance. Patients with reduced tidal volume have
inadequate negative-pressure ventilation and need positive-
pressure ventilation. If the patient's mental status does not improve
,NREMT P-medic: Airway Exam
Questions & Answers (Grade A+)
despite adequately performed ventilation assistance, intubation
should be considered.
You are ventilating a patient with massive maxillofacial trauma after
having successfully performed a needle cricothyrotomy. It is MOST
important that you: -
correct answer ✅Open the release valve on the jet ventilator
device just until the patient's chest visibly rises.
Cricothyrotomy—needle or surgical—is indicated when you are
unable to ventilate a patient by other, less invasive means (eg, bag-
mask device, intubation). If you are able to adequately ventilate the
patient after performing a needle cricothyrotomy, continue to do so
and rapidly transport; you have achieved your objective. As with
any other technique of ventilation, you must ensure the chest rises
adequately with each ventilation. After performing a needle
cricothyrotomy, this involves opening the release valve on the jet
ventilator just until the chest visibly rises. Extreme care must be
exercised when providing positive-pressure ventilation to any
patient. Overinflation of the lungs can cause barotrauma and a
resultant pneumothorax. An advantage of performing a
cricothyrotomy is that it does not require manipulation of the
cervical spine.
, NREMT P-medic: Airway Exam
Questions & Answers (Grade A+)
In contrast to the pneuomotaxic center of the medulla, the
apneustic center: -
correct answer ✅Influences the respiratory rate by increasing the
number of inspirations per minute.
The respiratory center in the medulla is divided into three regions:
the respiratory rhythmicity center, the apneustic center, and the
pneumotaxic center. The respiratory rhythmicity center sets the
resting respiratory rate. The apneustic center influences the
respiratory rate by increasing the number of inspirations per
minute. Its activity is countered by the pneumotaxic center, which
inhibits inspiration. In times of increased demand, the pneumotaxic
center decreases its influence, thereby increasing the respiratory
rate. As the chest wall expands, mechanical (stretch) receptors in
the lungs send a signal to the apneustic center via the vagus nerve
to inhibit the inspiratory center, and expiration occurs. This
feedback loop, which combines neural and mechanical control, is
called the Hering-Breuer reflex. It is a protective mechanism that
terminates inspiration, thus preventing overexpansion of the lungs.
A patient was bitten by fire ants and is unresponsive. He has severe
edema to the face and neck and generalized urticaria. Breath
sounds are difficult to hear, and loud inspiratory stridor is noted.
Questions & Answers (Grade A+)
After determining that your unresponsive patient has a severe
(complete) upper airway obstruction caused by a foreign body, you
should: -
correct answer ✅Perform chest compressions.
Once you have determined that your unresponsive patient has a
severe FBAO you should perform 30 chest compressions, open the
airway and visualize the mouth, and remove the foreign body only
if you can see it. Heimlich maneuver is indicated for responsive
adults and children with a severe FBAO.
A 16-year-old male presents with acute respiratory distress. His
mother tells you that he recently lost his job. He is conscious and
alert, but obviously anxious. He has a respiratory rate of 40
breaths/min and an oxygen saturation of 98% on room air. Further
assessment reveals carpopedal spasms to his hands. Initial
management for this patient should include: -
correct answer ✅Providing coaching to slow the patient's
breathing.
On the basis of the patient HX and physical findings, this case is
consistent with an anxiety attack and hyperventilation syndrome.
These patients initially need emotional support and respiratory
coaching. If the patient's respirations do not slow down after a
,NREMT P-medic: Airway Exam
Questions & Answers (Grade A+)
reasonable period of coaching, you should consider the presence of
another underlying cause, such as hypoxemia, and administer high-
flow oxygen. The causes of hyperventilation are many; acute
anxiety is but one of them. If you are able to successfully control
the patient's breathing, yet he is still experiencing anxiety, it would
not be unreasonable to administer a sedative drug, such as Valium,
provided that his vital signs are stable and his breathing remains
adequate.
A 56-year-old male presents with respiratory distress. He appears
tired and is slow to answer your questions. He is taking a series of
quick breaths, followed by prolonged exhalation. On the basis of
these clinical findings, you should: -
correct answer ✅Provide some form of positive-pressure
ventilation.
Your patient is not breathing adequately. His tired appearance and
delay in answering your questions are signs of decreased cerebral
perfusion secondary to inadequate ventilation. You must restore his
tidal volume by providing some form of positive-pressure
ventilatory assistance. Patients with reduced tidal volume have
inadequate negative-pressure ventilation and need positive-
pressure ventilation. If the patient's mental status does not improve
,NREMT P-medic: Airway Exam
Questions & Answers (Grade A+)
despite adequately performed ventilation assistance, intubation
should be considered.
You are ventilating a patient with massive maxillofacial trauma after
having successfully performed a needle cricothyrotomy. It is MOST
important that you: -
correct answer ✅Open the release valve on the jet ventilator
device just until the patient's chest visibly rises.
Cricothyrotomy—needle or surgical—is indicated when you are
unable to ventilate a patient by other, less invasive means (eg, bag-
mask device, intubation). If you are able to adequately ventilate the
patient after performing a needle cricothyrotomy, continue to do so
and rapidly transport; you have achieved your objective. As with
any other technique of ventilation, you must ensure the chest rises
adequately with each ventilation. After performing a needle
cricothyrotomy, this involves opening the release valve on the jet
ventilator just until the chest visibly rises. Extreme care must be
exercised when providing positive-pressure ventilation to any
patient. Overinflation of the lungs can cause barotrauma and a
resultant pneumothorax. An advantage of performing a
cricothyrotomy is that it does not require manipulation of the
cervical spine.
, NREMT P-medic: Airway Exam
Questions & Answers (Grade A+)
In contrast to the pneuomotaxic center of the medulla, the
apneustic center: -
correct answer ✅Influences the respiratory rate by increasing the
number of inspirations per minute.
The respiratory center in the medulla is divided into three regions:
the respiratory rhythmicity center, the apneustic center, and the
pneumotaxic center. The respiratory rhythmicity center sets the
resting respiratory rate. The apneustic center influences the
respiratory rate by increasing the number of inspirations per
minute. Its activity is countered by the pneumotaxic center, which
inhibits inspiration. In times of increased demand, the pneumotaxic
center decreases its influence, thereby increasing the respiratory
rate. As the chest wall expands, mechanical (stretch) receptors in
the lungs send a signal to the apneustic center via the vagus nerve
to inhibit the inspiratory center, and expiration occurs. This
feedback loop, which combines neural and mechanical control, is
called the Hering-Breuer reflex. It is a protective mechanism that
terminates inspiration, thus preventing overexpansion of the lungs.
A patient was bitten by fire ants and is unresponsive. He has severe
edema to the face and neck and generalized urticaria. Breath
sounds are difficult to hear, and loud inspiratory stridor is noted.
