Airway Scenarios Flashcards
A patient is lying supine in bed. They are unresponsive to verbal stimuli and having difficulty breathing. You note that the patient’s lips, face, and fingers are cyanotic And there’s pink, frothy sputum in the mouth and nose. You should first:
A. Suction the mouth and nose
B. Place the patient to a sitting position with feet dangling
C. Begin BVM ventilations
D. Applied Jaw Thrust
A. Suction the mouth and nose
We need to ensure the patient’s airway is patent, so clearing the airway of any potential obstructions comes 1st.
Without knowing the blood pressure, putting the patient into a sitting position, choice B, may be dangerous.
You may need to ventilate the patient, choice C, but the question doesn’t give enough information to make that decision.
None the information in the question suggests a trauma mechanism, choice D, would be an appropriate
A 7-month-old infant presents limp and unresponsive in his mother’s arms. You note no air exchange and a weak- brachial pulse. The mother reports that the infant was playing with toys in a crib when he suddenly went quiets, turned blue, and stopped breathing. You should:
A. Administer 5 chest thrusts
B. Suction the mouth
C. Administer 5 back blows and 5 chest thrusts
D. Begin chest compressions (30 chest thrusts)
D. Begin chest compressions (30 chest thrusts as the child has gone unresponsive)
A. A likely scenario for this presentation is a foreign body airway obstruction. Reserved for conscious/responsive children over the age of 1 year.
B. There’s no indication of an obstruction in the mouth, so suctioning isn’t indicated at this point.
C. Back blows and chest thrusts would indicate that the infant is still conscious/responsive.
The 16-year-old female says she is short of breath. She is alert and is speaking 7 to 8 words in between breaths. She has hives on her chest, and arms, and her skin is pale. You should:
A. Ventilate the patient with the BVM
B. Insert NPA
C. Administer supplemental oxygen
D. Apply continuous positive airway pressure
C. Administer supplemental oxygen
A - The patient is alert and responding appropriately, which indicates mild respiratory distress and not respiratory failure. A BVM would be inappropriate
B - Same as A
D - Patient has a near-normal speaking rate and does not exhibit any signs of respiratory distress or impending respiratory failure, thus CPAP would be appropriate.
An unconscious 25-year-old female has pale, cool, and diaphoretic skin. The respiratory rate is 6 times a minute. Your next step is to:
A. Administer abdominal thrust
B. Administer high flow oxygen
C. Ventilate with the BVM
D. Turn the patient onto her side
C. Ventilate with the BVM
The patient’s respiratory effort is too slow to support adequate ventilation, so you need to assist with the BVM.
A. There is no information to suggest she is experiencing a foreign body airway obstruction, making this option inappropriate.
B. High flow oxygen alone isn’t helpful without adequate rate and tidal volume
D. if her ventilations were adequate, the recovery position would be helpful in keeping the airway clear and preventing aspiration. This is not the case.
A 4-year-old was having difficulty breathing. He isn’t responding to your commands, and has cyanosis around his lips and fingers, and is drooling from his mouth. His parents report the patient has a high fever and didn’t want to lie down to rest. What should you do:
A. Administer oxygen via a blow-by mask
B. Ventilate using BVM
C. Apply nasal cannula and oxygen at 6 L per minute
D. Administer combination of back blows & abdominal thrusts
B. Ventilate using BVM
This child appears to have signs of upper airway obstruction, likely due to epiglotittis, which can cause upper airway obstruction due to severe inflammation. He is unresponsive and cyanotic, thus has signs of an impending respiratory failure and needs manual ventilation.
A. Supplemental oxygen is inadequate
C. Supplemental oxygen is inadequate
D. There are no signs of a foreign body airway obstruction, so back blows and abdominal thrusts aren’t appropriate.
A 56-year-old male with a history of asthma complains of substernal chest pressure that radiates to the jaw. He is alert, with cool, pale, and diaphoretic skin. His respiratory rate is 24 breaths per minute, and lung sounds are clear. You should:
A. Assist his breathing with the BVM
B. Assist with patients MDI
C. Lay the patient supine with his legs elevated
D. Administer supplemental oxygen using a nasal cannula
D. Administer supplemental oxygen using a nasal cannula
The patient’s clinical presentation is concerning for acute coronary syndrome. Oxygen supplementation as part of the ACS protocol. He appears to have adequate breathing, based on his rate and lung sounds.
A. Patient has adequate breathing-therefore he does not need BVM assistance
B. The chief complaint sounds more like an MI than asthma, making this treatment unlikely to help.
C. Placing the patient in the supine position with legs elevated is more likely to help if he has orthostatic hypotension.
Lifeguards have pulled a 7-year-old child out of the pool. She is unresponsive and apneic with a rapid carotid pulse. What should you do:
A. Assist ventilations with the BVM
B. Begin chest compressions with a rate of at least 100 times per minute
C. Apply AED pads bear for shock
C. Suction the mouth and nose
A. Assist ventilations with the BVM
The patient is in respiratory arrest and requires manual ventilation.
B. She is not in cardiac arrest making compressions unnecessary at this point.
C. She is not in cardiac arrest which is contraindicative of an AED.
D. There is no indication of secretions or water in the upper airway, so suctioning is not indicated.
56-year-old males alert and in respiratory distress after being rescued from a burning apartment. He notes it on his face and soot-tinged secretions from his mouth and nose. There is an audible strider when he breathes. He is able to speak in 4 to 5-word sentences with a hoarse voice. You should:
A place in supine and assist with ventilation
B. Placing supine and administer a supplemental oxygen
C. Have him sit if tolerated, and administer supplemental oxygen
D. Have him sit if tolerated, and assist with ventilation
C. Have him sit if tolerated, and administer supplemental oxygen
The patient has a smoke inhalation injury. Strider and a hoarse voice indicate some type of restriction in the upper airway. Having the patient in a sitting position is most likely to promote optimal airway patency.
A. Laying the patient supine would most likely make the airway restriction worse
B. Laying the patient supine would most likely make the airway restriction worse
D. The patient is alert and still able to speak. Ventilation is not indicated.
