Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Emergency Medical Technician > Chapter 10 | Respiration and Artificial Ventilation > Flashcards

Chapter 10 | Respiration and Artificial Ventilation Flashcards

• Physiology and pathophysiology of the respiratory system • How to recognize adequate and inadequate breathing • Principles and techniques of positive pressure ventilation • Principles and techniques of oxygen administration

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards USMLE® Step 1 flashcards
1
Q

Define:

tidal volume

A

amount of air moved in one breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define:

dead air space

A

air moved in ventilation not reaching alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define:

alveolar ventilation

A

air actually reaching alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define:

ventilation

A

both inhaling and exhaling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define:

diffusion

(respiration)

A

movement of gases from high concentration to low concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define:

external respiration

A

exchange of gasses between alveoli and circulating blood

O₂ and CO₂

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Define:

internal respiration

cellular respiration

A

exchange of gases between blood and cells

O₂ and CO₂

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Answer:

If a patient is hypoxic, one of three body processes have likely been disrupted. What are they?

A
  • ventilations: mechanics of breathing disrupted
  • respirations: gas exchange interrupted
  • perfusion: circulation interrupted
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Define:

hypercapnia

A

high carbon dioxide (CO₂) level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define:

hypercarbia

A

high carbon dioxide (CO₂) level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define:

hypocarbia

A

low carbon dioxide (CO₂) level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define:

hypocapnea

A

low carbon dioxide (CO₂) level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

List (in order):

stages of respiratory compensation

3 points

A
  1. respiratory distress
  2. respiratory failure
  3. respiratory arrest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Define:

respiratory distress

A

body compensating for a respiratory challenge and meeting metabolic needs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

List:

assessment findings that align with respiratory distress

7 points (think early asthma attack)

  • mental status
  • O₂ saturation
  • skin condition
  • breathing difficulty
  • RR
  • HR
  • patient presentation
A
  • relatively normal mental status
  • relatively normal SpO₂ (and end tidal carbon dioxide)
  • relatively normal skin color
  • dyspnea (shortness of breath)
  • increased RR
  • increased HR
  • accessory muscle use (and position of stress)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define:

respiratory failure

A

stage of respiratory compensation that occurs when respiratory challenge overcomes compensation or compensatory steps can no longer continue

(AKA inadequate breathing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

List:

signs of respiratory failure

5 points (think late choking)

A
  • signs of hypoxia
  • no/poor air movement
  • irregular breathing
  • inability to speak
  • unusual breathing noises
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Define:

respiratory arrest

A

when breathing completely stops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define:

positive pressure ventilation (PPV)

A

forcing air or oxygen into lungs when a patient has stopped breathing or has inadequate breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Fill in the blank:

Positive pressure ventilation uses force that is [BLANK].

A

Positive pressure ventilation uses force that is exactly opposite of how the body normally draws air into the lungs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

List:

negative side effects of positive pressure ventilations

3 points

A
  • hyperventilation
  • gastric distention
  • decreasing cardiac output and/or dropping blood pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Explain:

proper spacing of positive pressure ventilations

A

1 respiration for every 5-6 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Define:

bag-valve mask (BVM)

A

handheld ventilation device

used to ventilate patient in respiratory failure/arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Explain:

proper squeezage of BVM

A

just enough for chest to rise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Explain:

how to propely seal BVM on face

A

E-C clamp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Fill in the blank:

[DO/DON’T] ventilate a patient who is vomiting or has vomitus in airway.

A

Do not ventilate a patient who is vomiting or has vomitus in airway.

(may force vomitus into lungs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

List:

steps in responding to no chest rise during BVM

4 points

A
  • reposition head
  • check for escape around mask (reposition fingers/mask if necessary)
  • check airway for obstruction
  • use alternative method
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Fill in the blank:

A stoma breather has [BLANK].

A

A stoma breather has a surgical opening in the neck.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Explain:

artificial ventilation of a stoma breather

A

use pediatric mask to establish seal around stoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Define:

flow-restricted oxygen-powered ventilation device

A

manually-triggered ventilation device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Define:

automatic transport ventilator (ATV)

A

machine which provides automated ventilations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Fill in the blank:

When using an automatic transport ventilator, provider must assure the appropriate [BLANK] for patient’s size and condition.

A

When using an automatic transport ventilator, provider must assure the appropriate respiratory rate and volume for patient’s size and condition.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Fill in the blank:

Oxygen makes up [BLANK] percent of the atmosphere.

A

Oxygen makes up 21 percent of the atmosphere.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

List:

occassions when providing oxygen may be beneficial

6 points

A
  • respiratory distress
  • respiratory/cardiac arrest
  • lung diseases
  • head injuries
  • other serious injuries (trauma)
  • shock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

List:

parts of pressure regulator

4 points (giving oxygen)

A
  • flowmeter
  • high pressure port
  • pressure guage
  • nipple
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Fill in the blank:

When providing oxygen, use [BLANK], [BLANK], and [BLANK] intended for use with oxygen.

A

When providing oxygen, use pressure gauges, regulators, and tubing intended for use with oxygen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Fill in the blank:

[DO/DON’T] allow smoking around oxygen or use oxygen equipment around open flame.

A

Don’t (never) allow smoking around oxygen or use oxygen equipment around open flame.

38
Q

Fill in the blank:

[DO/DON’T] use grease or adhesive tape on a cylinder.

A

Don’t (never) use grease or adhesive tape on a cylinder.

39
Q

Fill in the blank:

[DO/DON’T] test cylinders hydrostatically every 5 years.

A

Do test cylinders hydrostatically every 5 years.

40
Q

Define:

nonrebreather mask

A

best way to deliver high concentrations of oxygen to a breathing patient

41
Q

Define:

nasal cannula (NC)

A

best choice for a patient who refuses to wear an oxygen face mask or for titration

42
Q

Define:

partial rebreather mask

A

rebreather mask without reservoir bag

uncommon

43
Q

Define:

venturi mask

A

mask that delivers specific concentrations of oxygen by mixing with inhaled air

44
Q

Define:

tracheostomy mask

A

mask placed over stoma or tracheostomy tube to provide supplemental oxygen

45
Q

Explain:

purpose of humidifier connected to flowmeter

A

provides moisture to dry oxygen from supply cylinder

prevents drying out mucus membranes with just oxygen

46
Q

Define

endotracheal intubation (ET)

A

intubating a patient through trachea

47
Q

Explain:

ways EMTs can assist with intubation

4 points

A
  • maximize oxygenation prior to procedure
  • position patient in sniffing position
  • cricoid pressure (pushing vocal chords into view)
  • securing tube in place
48
Q

Fill in the blank:

[BLANK] can displace an endotracheal tube.

A

Very little movement can displace an endotracheal tube.

49
Q

Answer:

Your patient is a 55-year-old man with a history of chronic bronchitis. You have been called to his home today because of an increase in his level of respiratory distress. The patient is on 2 liters per minute of oxygen by nasal cannula at home. Your assessment reveals difficulty speaking due to shortness of breath, leaning forward to breathe, a productive cough, and a respiratory rate of 32 per minute.

What is the best course of action for this patient?

A

You should increase the patient’s oxygen flow rate to deliver adequate amounts of oxygen to his tissues.

If his respiratory rate decreases, you can assist him with a bag-valve-mask device.

50
Q

Answer:

The paramedic is intubating a patient and asks you to assist by gently pressing your thumb and index finger to either side of the throat just over the patient’s Adam’s apple. As you press, you gently direct the throat upward and to the patient’s right.

What is the purpose of this maneuver?

A

It pushes the patient’s vocal cords into the paramedic’s view.

51
Q

Answer:

Which colors identify an oxygen cylinder?

A

green and white

52
Q

Answer:

What is the best device to deliver high-concentration oxygen to a breathing patient?

A

nonrebreather mask

53
Q

Answer:

The normal urge to breathe is stimulated by chemoreceptors that measure changing levels of what two gases?

A

carbon dioxide (CO₂) and oxygen (O₂)

54
Q

Fill in the blank:

You are attempting to replace the oxygen cylinder in your truck. After removing the regulator from the old cylinder, removing the old cylinder, and placing the new cylinder in the oxygen compartment, you attempt to connect the regulator. The new cylinder is yellow rather than green, but it was stored with the green cylinders. You are unable to get the regulator to seat properly and it will not turn. You should [BLANK].

A

You should remove the yellow cylinder and get a green cylinder.

55
Q

Answer:

How could fast respiration decrease minute volume?

A

The lungs may not have adequate time to fill and exchange gas.

56
Q

Answer:

On arrival at the emergency scene, you find an adult female patient who is semi-conscious. Her respiratory rate is 7 breaths per minute. She appears pale and slightly blue around her lips.

What immediate actions are necessary? Does this patient require artificial ventilations?

A

after donning PPE and ensuring the scene is safe, the EMT should first open this patient’s airway

(if necessary) support it with an airway adjunct and suctioning as appropriate

this patient needs immediate respiratory assistance with a BVM and supplemental oxygen

57
Q

Answer:

On arrival at the emergency scene, you find an adult female patient who is semi-conscious. Her respiratory rate is 7 per minute. She appears pale and slightly blue around her lips.

Is this patient in respiratory failure, and if so, what signs and symptoms indicate this?

A

Yes, her altered mental status, slow respiratory rate, and cyanosis all point to respiratory failure.

58
Q

Answer:

On arrival at the emergency scene, you find an adult male patient sitting bolt upright in a chair. He looks at you as you come into the room, but he is unable to speak more than two words at a time. He seems to have a prolonged expiratory phase; you hear wheezes, and his respiratory rate is 36.

What immediate actions are necessary?

A

(at a minimum) patient needs immediate supplemental oxygen

assess further to determine respiratory failure

59
Q

Answer:

On arrival at the emergency scene, you find an adult male patient sitting bolt upright in a chair. He looks at you as you come into the room, but he is unable to speak more than two words at a time. He seems to have a prolonged expiratory phase; you hear wheezes, and his respiratory rate is 36.

Is this patient in respiratory failure, and if so, what signs and symptoms indicate this?

A

further assessment necessary to identify respiratory failure

inability to speak and position certainly signify potential impending failure

60
Q

Answer:

On arrival at the scene of a motor-vehicle crash, you find an adult female patient pacing outside her damaged vehicle. She appears to be breathing very rapidly but acknowledges you as you approach. Her color seems normal, and her respiratory rate is 48.

What immediate actions are necessary?

A

Although this patient may just be anxious after the motor-vehicle crash, a thorough assessment must be completed to ensure the fast respiratory rate is not due to an injury.

61
Q

Answer:

On arrival at the scene of a motor-vehicle crash, you find an adult female patient pacing outside her damaged vehicle. She appears to be breathing very rapidly but acknowledges you as you approach. Her color seems normal, and her respiratory rate is 48.

Is this patient in respiratory failure, and if so, what signs and symptoms indicate this?

A

Not likely, but further assessment necessary

Rapid respiratory rates can indicate inadequate breathing, but further assessment will be necessary to identify respiratory failure. The information provided (i.e., she is walking around, is alert, and has normal skin color) seems to indicate that at this time the patient is not in respiratory failure and will likely not need artificial ventilations.

62
Q

Choose:

A

C

63
Q

Choose:

A

D

64
Q

Choose:

A

B

65
Q

Choose:

A

D

66
Q

Choose:

A

D

67
Q

Choose:

A

B

narcotics taken in excess can cause respiratory depression and may lead to hypoxia

68
Q

Choose:

A

B

hyperventilation can lead to lower BP, vasoconstriction, and limited flow O₂ to brain

69
Q

Choose:

A

D

use the jaw-thrust maneuver instead (because it’s a trauma patient)

70
Q

Choose:

A

D

BVM should be used with oral airway

reservoir bag and O₂ tank should always be used

71
Q

Choose:

A

A

priority is always to treat respiratory distress with high-flow and high-concentration O₂

72
Q

Choose:

A

D

73
Q

Choose:

A

B

patient has decreased respiratory execution due to rib fractures

higher RR may cause lower tidal volume

reduced tidal volume might prevent adequate O₂ intake

74
Q

Define:

AMS

(acronym)

A

altered mental status

75
Q

Define:

BVM

(acronym)

A

bag-valve mask

76
Q

Fill in the blank:

Do not use an NPA on a patient with [BLANK] or [BLANK].

A

Do not use an NPA on a patient with facial injury or skull fracture.

77
Q

Answer:

When should you use a BVM on a patient?

3 points

A
  • low RR
  • shallow breathing
  • agonal breathing
78
Q

Explain:

What are 2 components that define inadequate breathing? How do we treat them?

A

low RR or shallow breaths

To treat, provide artificial ventilations (with a BVM)

79
Q

Fill in the blank:

For normal breathing, air is brought into the lungs through inhalation with a [POSITIVE/NEGATIVE] pressure.

A

air is brought into the lungs through inhalation with a negative pressure.

80
Q

Fill in the blank:

When conducting artificial ventilation, air is brought into the lungs through inhalation with a [BLANK] pressure.

A

air is brought into the lungs through inhalation with a positive pressure.

pushing air out of BVM opposite of how lungs work

81
Q

Fill in the blank:

For normal breathing, air is pushed out of the lungs through exhalation with a [POSITIVE/NEGATIVE] pressure.

A

air is pushed out of the lungs through exhalation with a positive pressure.

82
Q

Fill in the blank:

When conducting artificial ventilation, air is pushed out of the lungs through exhalation with a [BLANK] pressure.

A

air is pushed out of the lungs through exhalation with a negative pressure.

The pressure filling the BVM is pulling in air the way the lungs would.

83
Q

Fill in the blank:

Respiratory failure occurs when [BLANK] is no longer effective.

A

Respiratory failure occurs when respiratory compensation is no longer effective.

84
Q

Choose:

Which of the following muscles are located within the chest wall and assist with exhalation to the greatest degree?

A. diaphragmatic muscles

B. retroperitoneal muscles

C. intercostal muscles

D. coracobrachialis muscles

A

C

The intercostal muscles are critical to exhalation. These muscles lie between the ribs and help to bring the ribs closer together. This reduces the size of the chest cavity and allows the natural recoil of the lungs to force air out of the body.

The diaphragm is the other major muscle of respiration. It does not assist with exhalation but rather inhalation. Moving downwards at the base of the chest cavity, this expands the cavity and creates negative pressure which forces air into the lungs.

85
Q

Choose:

Which phase of respiration does the transfer of oxygen and carbon dioxide between inspired air and the pulmonary capillaries take place?

A. Internal respiration

B. Aerobic respiration

C. External respiration

D. Anaerobic respiration

A

C

External respiration is the exchange of gases between the alveoli of the lungs and the blood. During the external respiration phase, the transfer inspired air and the pulmonary capillaries take place.

Internal respiration is the exchange of gases between the cells and the blood. Failure of Internal respiration is almost always due to failing external respiration. The few things that affect internal respiration directly are blood loss and cyanide poisoning.

86
Q

Choose:

You arrive on the scene of a cardiac arrest in which bystanders are performing CPR. The compressions are adequate. They are ventilating the patient via a pocket mask without oxygen.

What is the maximum percentage of oxygen this type of ventilation can deliver to the patient?

A. 10%

B. 13%

C. 16%

D. 21%

A

C

The maximum amount of oxygen delivered via rescue breathing without supplemental oxygen is 16% because you’re just ventilating with exhaled air. This, on average, is 16% oxygen and is sufficient when no other options are available. However, it should be supplemented with oxygen or replaced with another ventilation method (such as a bag-valve mask) as soon as possible.

87
Q

Choose:

A respiration rate would be considered within normal limits for an adult at [BLANK] per minute, a school-age child at [BLANK] per minute, and an infant at [BLANK] per minute.

A. 20 - 40 - 60

B. 16 - 25 - 40

C. 22 - 32 - 42

D. 10 - 20 - 40

A

B

According to multiple sources, normal adult respiratory rates are from 12-20, school-age children (6-12) are 18-30, and infants are 30-60.

Note: Respiratory rates for late adulthood, 61+, is dependent on the patient’s physical and health status.

88
Q

Choose:

What physiological difference is found with artificial ventilation that is not a concern when a patient has total control over their own ventilation?

A. Positive pressure is created in the chest during inspiration

B. Blood return to the heart is increased

C. The esophagus opening is forced to close by air pressure

D. Negative pressure is created between the pleura during inhalation

A

A

Artificial ventilation creates positive pressure in the chest during inhalation, as opposed to the negative pressure normally created during natural respiration. The other answers are not created by artificial ventilation. During artificial ventilation, blood return to the heart is decreased because of the pressure in the chest cavity; this decreases cardiac output. The esophagus may be forced open by the air pressure in the nasopharynx; healthcare providers must watch for gastric inflation because of this.

89
Q

Choose:

You are dispatched to a patient with acute shortness of breath. She is conscious, but confused, and is gasping for air. Your pulse oximeter is reading 74% on room air.

Which of the following is the best respiratory intervention for this patient?

A. 15 liters of oxygen per minute via NRB

B. insert an oral airway and begin positive pressure ventilations

C. assisted positive pressure ventilation with oxygen

D. needle decompression of the bilateral chest

A

C

This patient has altered mental status, hypoxemia, and gasping breaths, all three of these are warning signs for inadequate ventilation. The combination of the three should lead you to the conclusion that ventilations need to be assisted as opposed to only oxygen being provided.**

90
Q

Choose:

An unresponsive patient is breathing on his own at 6-8 breaths per minute. He is cyanotic around the nose and mouth. You are unable to palpate a radial pulse.

You should:

A. Initiate chest compressions only

B. Begin assisting ventilations with a BVM and 100% O2 at 10-12 breaths per minute

C. Check responsiveness and initiate CPR

D. Assess the situation further

A

B

A patient breathing 6-8 times per minute with no radial pulse is not in full cardiac arrest.

Begin immediately assisting his respirations with a BVM and 100% O2 while assessing the situation further. Additionally, you should assess for a carotid pulse. The immediate need is that this patient needs more oxygenated air now!

Emergency Medical Technician (41 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions