Component 3: Airway Management Techniques and Tools

Question 1

Differentiate visceral pleura and parietal pleura.

Answer 1

• Visceral pleura is the slippery outer membrane encompassing the lung tissue.
• Parietal pleura lines the inside of the thoracic cavity.

Question 2

What is the fluid between the two pleura membranes called?

Answer 2

pulmonary surfactant

Question 3

What nerve stimulates the diaphragm muscle to contract?

Answer 3

phrenic nerve

Question 4

Where is the heart located in the thoracic cavity?

Answer 4

mediastinum

Question 5

Define:

ventilation

Answer 5

It is the physical action of moving air in and out of the lungs.

Question 6

Define:

oxygenation

Answer 6

It is the loading of oxygen molecules onboard the hemoglobin in the bloodstream.

Question 7

Define:

respiration

Answer 7

It is the exchange of oxygen and carbon dioxide in the capillaries on the alveoli and other tissues of the body.

(O₂), (CO₂)

Question 8

What are the two actions of ventilation?

Answer 8

inhalation and exhalation

Question 9

Why is it important to create or secure a patent airway for a patient without a gag reflex?

Answer 9

A patient with no gag reflex cannot maintain a patent airway. We must provide a patent airway for oxygenation and possible positive pressure ventilation if needed.

(PPV)

Question 10

True or false.

There is no difference between internal and external respiration.

Answer 10

False

Internal respiration occurs at a cellular level for tissues and organs.

External respiration is the initial action of breathing air in, and the gas exchange at the alveolar level.

Question 11

What is it called when the cells can no longer metabolize the oxygen deprivation?

Answer 11

anaerobic metabolism

Question 12

Fill in the blank.

The ________ is the most common airway obstruction.

Answer 12

tongue

Question 13

True or false.

If the patient has a suspected spinal injury, it is appropriate to use a jaw-thrust maneuver.

Answer 13

True

The head-tilt, chin-lift maneuver may complicate any underlying injuries to the cervical spine.

Question 14

Describe:

adequate breathing

Answer 14

• a normal respiratory rate (12 to 20 breaths/min),
• a regular pattern of inhalation and exhalation,
• lung sounds will be clear and equal bilateral,
• equal chest rise and volume

Question 15

A patient is unconscious, unresponsive, and has snoring respirations at 5 breaths/min. What are the steps for airway and ventilation management?

Answer 15

1. If there is a suspected spinal injury, open the airway with a jaw-thrust maneuver maintaining c-spine alignment.
2. If no injury is suspected, open the airway with a head-tilt/chin-lift maneuver.
3. Suction as necessary.
4. Size and insert an oral pharyngeal airway, and place the mask of the bag-valve-mas over the patient’s mouth and nose.
5. Ventilate while watching for equal chest rise and fall.

Question 16

Describe:

agonal gasps and/or breathing

Answer 16

It is described as intermittent and inadequate gasps.

Question 17

List the muscles used when the patient is demonstrating labored or difficulty breathing.

Dyspnea

Answer 17

• Sternocleidomastoid
• Pectoralis major
• Intercostals
• Abdominal

Question 18

What is the breathing pattern called that has irregular pattern(s) with periods of apnea?

Answer 18

Cheyne-Stokes

Question 19

List the causes of inaccurate pulse oximetry readings.

Answer 19

• nail polish
• carbon monoxide poisoning
• severe distal vasoconstriction (chronic hypoxia, smoking, hypothermia)
• hypovolemia
• dirty fingers/nail beds

Can you think of any more?

Question 20

Describe:

capnography

Answer 20

It measures end-tidal carbon dioxide and provides a numerical reading and graph of CO₂ in the patient’s respirations.

Question 21

What is the normal capnography mm Hg reading range?

Answer 21

35 to 45 mm Hg

Question 22

List the types of airway obstruction(s).

Answer 22

• relaxed tongue
• foreign bodies (food, objects, dentures)
• swelling of the airway tissues
• trauma
• emesis/vomiting

Can you think of any more?

Question 23

What is the concern if we insert the suction catheter too far into the semi-conscious patient’s oropharynx?

Answer 23

• stimulation or triggering of the patient’s gag reflex
• inducing vomiting

Question 24

When is inserting an oropharyngeal indicated?

(OPA)

Answer 24

In unresponsive patients (breathing or apneic) when their gag reflex is no longer intact.

Question 25

# True or false. When measuring the appropriate size of an **oropharyngeal airway** for placement, we measure from the corner of the mouth to the tip of the earlobe.

Answer 25

True

Question 26

# Describe: The measurement of a **nasopharyngeal airway**. | NPA

Answer 26

An NPA should be measured from the **tip of the patient's nose** to the **tip of their earlobe.**

Question 27

When providing **positive pressure ventilation**, you notice the patient's dentures have come loose. Should you **continue to ventilate** or **remove the dentures** and then continue to ventilate? | PPV

Answer 27

**Remove the dentures** to prevent them from becoming an airway obstruction.

Question 28

What type of **lubricant** is used when preparing a **nasopharyngeal airway** for insertion?

Answer 28

water-soluble lubricant

Question 29

# True or false. The **BVM** should be hooked up to **15 LPMs** of oxygen (O₂).

Answer 29

True

Question 30

Upon inhalation, does the **diaphragm** contract or relax?

Answer 30

When inhaling, the diaphragm will **contract** to pull downward, **drawing air inward.**

Question 31

# True or false. When applying a **Non-Rebreather Mask**, the mask should be prefilled with no less than **10 L/min**.

Answer 31

True ## Footnote If the non-rebreather mask is filled with less than 10 L/min, the reservoir bag will not fill appropriatly.

Question 32

What is the **benefit** of cracking the valve on the oxygen (O₂) tank prior to assembling the regulator/gauge?

Answer 32

To **blow out any lint or debris** that may obstruct the flow of oxygen (O₂) through the regulator. ## Footnote For safety, when clearing the valve, point the opening away from anyone, including yourself.

Question 33

What is the **oxygen (O₂) flow rate** for a nasal cannula?

Answer 33

between **1 and 6 L/min**

Question 34

List oxygen-delivery **devices**

Answer 34

* nasal cannula * non-rebreather mask * BVM with reservoir * mouth to mask * venturi mask

Question 35

What does the presence of **cyanosis** indicate?

Answer 35

It indicates that the patient is suffering from **poor circulation and/or poor oxygenation.**

Question 36

What does it mean if the patient is **apneic**?

Answer 36

It refers to the **absence of breathing**, meaning the patient is **not breathing**.

Question 37

# Define: In reference to airway management, define **aspiration**.

Answer 37

It is vomitus, liquids, blood, or other foreign substances **entering the lungs**.

Question 38

How much **supplemental oxygen (O₂)** is administered when using a **non-rebreather mask**?

Answer 38

Up to **90%** O₂ on inspiration.

Question 39

How do we **prefill the reservoir bag** before we apply the mask to the patient?

Answer 39

**Place a gloved finger over the one-way valve** of the non-rebreather mask, and prefill the reservoir bag.

Question 40

What is the **point** where the left and right mainstem bronchi **bifurcate**?

Answer 40

They bifurcate at the **carina**.

Question 41

You are providing **positive pressure ventilation** (PPV) with a **bag-valve-mask** and are not getting any chest rise. What should you do? | BVM

Answer 41

We should **re-adjust and re-evaluate the airway** because there is non-compliance with PPV.

Question 42

List **contraindications** for the application of Continuous Positive Airway Pressure. | CPAP

Answer 42

* The patient is apneic. * Signs and/or symptoms of chest trauma or a pneumothorax. * The patient is actively vomiting. * The patient cannot follow commands. * A patient with a tracheostomy.

Question 43

If we are providing positive pressure ventilation (PPV) too aggressively with **too much oxygen** (O₂), what will most likely **develop**, and what is the **concern**?

Answer 43

* **Gastric distention** will develop and cause an additional airway concern of **emesis/vomit**. * It may lead to **aspiration** when being too forceful and aggressive when providing PPV with a bag-valve-mask (BVM).

Question 44

# Describe: Describe how to perform a **jaw-thrust** maneuver.

Answer 44

With a supine patient: * Place the head in the **in-line position**. * Place your fingers **behind** the angle of the jaw and lift, or **pull up with your fingers**. ## Footnote This technique will pull a relaxed tongue off the back of the pharynx.

Question 45

What is the **amount of air** (in mLs) that we move in and out in one breath called?

Answer 45

tidal volume

Question 46

When inserting a **nasopharyngeal airway** (NPA), where should the **bevel** be?

Answer 46

It should be placed **against the nasal septum** whether **right or left** nare insertion.

Question 47

# True or false. The nasopharyngeal airway (NPA) will **hold the tongue** of the posterior aspect of the throat.

Answer 47

False ## Footnote A correctly placed NPA's tip will be seen posterior to the uvula. An oropharyngeal airway (OPA) will displace the tongue to allow for air to pass.

Question 48

What **anatomy** separates the upper from the lower **airways**?

Answer 48

The **larynx** separates the upper and lower airways, and is protected by the **cricothyroid cartilage**.

Question 49

# True or False Oxygen (O₂) is a **prescribed** medication.

Answer 49

True

Question 50

When providing **rescue breaths** for an adult, how often do we provide **ventilation**?

Answer 50

**One breath** (over one second) every **five to six** seconds.

Question 51

# True or false. When placing a **nasal cannula** on a patient, it is best to have the **oxygen flow meter set**.

Answer 51

False ## Footnote Make certain the flow meter is off, apply the cannula, and then set the flow between 1 and 6 L/min.

Question 52

What is the easiest way to quickly master your knowledge of airway management, respiration, and ventilation for **paramedic training**?

Answer 52

Brainscape's [EMT-P (1) Airway, Respiration, and Ventilation](https://www.brainscape.com/learn/nremt-paramedic?utm_source=crosslink&utm_medium=in-app&utm_campaign=in-app) Flashcards