Chapter 9/10

Question 1

Four sounds of obstructed airway

Answer 1

1) Stridor: high pitched whistling sound; indicative of severely narrowed air passage

2) Hoarseness: raspy change in voice; indicative of swelling around the vocal cords

3) Snoring: similar to a snore during sleep; indicative of diminished muscle tone

4) Gurgling: bubbling sound; indicative of bodily fluid in the airway

Question 2

Airway adjuncts

Answer 2

Oropharyngeal airway (OPA)
* Only use on patients without gag reflex

Nasopharyngeal airway (NPA)
* Used when there is gag reflex
* Not used in patients with nose or head injuries

• Keeps the tongue from blocking the airway
• When inserting any airway adjuncts, be ready with suction

Question 3

Supraglottic airway

Answer 3

• Isolate the glottic opening by occupying space in the larynx and hypopharynx
• Used if basic methods fail and airway must be maintained over a long period

Question 4

Pulmonary respiration

Answer 4

Diffusion of oxygen and CO2 between the alveoli and the circulating blood

Question 5

Hypoxia

Answer 5

Low levels of oxygen

Question 6

Hypercapnia

Answer 6

High levels of CO2

Question 7

Cyanosis

Answer 7

Skin becoming blue with inadequate respiration and blood flow

Question 8

Positive pressure ventilation

Answer 8

Form of respiratory therapy that involves the delivery of air or a mixture of oxygen combined with other gases by positive pressure into the lungs

• Method applies higher air pressure to the lungs

Question 9

3 methods of positive pressure ventilation

Answer 9

Mouth to mask
Two rescuer bag valve mask (BVM)
One rescuer bag valve mask (BVM)

• Watch the chest rise and fall with each ventilation
• Ensure the rate of ventilation is sufficient

Question 10

When ventilating a patient who is breathing slowly

Answer 10

Add ventilation in between the patient’s own to increase the rate to 12 per minute

Question 11

Artificial ventilation of a stoma breather

Answer 11

1. Clear mucus plugs or secretions from stoma
2. leave the head/neck in the neutral position
3. Use a pediatric sized mask to establish a seal around the stoma
4. Ventilate at the appropriate rate for the patient’s age
5. If unable to ventilate through stoma, seal the stoma and attempt ventilation through the mouth and nose

Question 12

Adults and child ventilation rate

Answer 12

Adults should be ventilated 10-12 times per minute

Children should be ventilated 12-20 times per minute

Question 13

Too slow ventilation can cause ________

Answer 13

hypoventilation and hypoxia

Question 14

Too fast ventilation can cause ________

Answer 14

hyperventilation and vasoconstriction

Question 15

Too much pressure causes __________

Answer 15

gastric distention

Question 16

Too much volume can cause _________

Answer 16

lung tissue trauma

Question 17

Automatic transport ventilator (ATV)

Answer 17

provides positive pressure ventilations during respiratory arrest

Question 18

Oxygen tank:
D cylinder
E cylinder
M cylinder
G cylinder
H cylinder

Answer 18

350 L of oxygen
625 L of oxygen
3000 L of oxygen
5300 L of oxygen
6900 L of oxygen

Question 19

Safe working pressure of oxygen

Answer 19

30-70 psi

Question 20

2 types of low pressure oxygen flowmeters

*** High pressure flowmeters may be needed for oxygen powered devices or respirators and ventilators

Answer 20

Pressure compensated flow meters are used for larger cylinders in the ambulance

Constant flow selector valve can be used with any size cylinder

Question 21

Supplemental oxygen for patients with chest pain

Answer 21

For mild distress, administer low concentration oxygen via nasal cannula (24-44% oxygen)

For moderate/severe distress, administer high concentration oxygen via nonrebreather mask (80-90% oxygen)

• Partial rebreather mask: allows the patient to rebreathe about one-third of the exhaled air. This is useful to preserve CO2 levels to stimulate breathing. (40-60% oxygen at 9-10 L per minute)
• Venturi mask: delivers specific concentrations of oxygen by mixing oxygen with inhaled air. Used in COPD patients.
• Tracheostomy mask: placed over a stoma or tracheostomy tube to provide supplemental oxygen (8-10 L per minute of oxygen)

Question 22

Oxygen delivered by the cannula should not exceed _________

Answer 22

4-6 L per minute