Case 1 - Respiratory Arrest

Question 1

Which of the following is considered a normal RR for adult patients?

A. 6-8 breaths/min
B. 12-16 breaths/min
C. 20-24 breaths/min

Answer 1

B. 12-16 breaths/min

Question 2

What is normal tidal volume for an adult with a normal respiratory rate and no disease processes?

A. 6-8 mL/kg
B. 7-9 mL/kg
C. 8-10 mL/kg

Answer 2

C. 8-10 mL/kg

Question 3

List the 8 signs (according to the AHA) that are present in respiratory distress.

Answer 3

1. Tachypnea
2. Increased respiratory effort (nasal flaring, retractions)
3. Inadequate respiratory effort (hypoventilation/bradypnea)
4. Abnormal airway sounds
5. Tachycardia
6. Pale, cool skin
7. ALOC/agitation
8. Use of abdominal muscles for breathing

Question 4

T/F: Respiratory failure occurs when compensatory mechanisms fail.

Answer 4

True.

Question 5

Respiratory failure requires intervention to prevent _____.

A. Cardiac arrest
B. Apnea

Answer 5

A. cardiac arrest

Question 6

What tidal volume (in mL/kg) is correlated to adequate chest rise with the BVM?

Answer 6

6-7 mL/kg

Question 7

Explain why excess ventilation may harm the patient?

Answer 7

Excessive ventilation may produce the following:

• “breath stacking” - not enough time for exhalation
• gastric inflation
• increased intrathoracic pressure decreasing venous return
• hyperventilation produces cerebral vasoconstriction

Question 8

Outline the steps of BLS assessment/Tx of respiratory arrest.

Answer 8

1. Tap/shout, “Are you okay?”
2. Call for help/send someone to get AED
   
   • if alone, get the AED yourself
3. Scan for breathing (5-10 seconds)/check pulse simultaneously
4. Provide supplemental oxygen to rates between 94-100%
5. Open airway and provide 1 breath q5-6 seconds
6. Check pulse q2m. If no pulse, begin CPR.

Question 9

When is CPR started on the choking patient?

Answer 9

When the patient is unresponsive and/or in respiratory arrest.

Question 10

Measuring and inserting the OPA:

Answer 10

• measure from tip of ear (curve) to the corner of mouth (flange)
• insert with curve toward the hard palate, then rotate 180 degrees

Question 11

When is a hard suction catheter used?

Answer 11

• suction oropharynx

- suction thick, particulate matter

Question 12

When is a soft suction catheter used?

Answer 12

• thin secretions in oro/nasopharynx
• intratracheal suctioning
• suctioning an “in-place airway” (like an NPA)