EMT 221 Flashcards
about how much of the carbon dioxide in the blood is attached to protein?
20%
if you are experiencing difficulty placing an Endotracheal tube into an older female patient you should
use magill forceps to help guide the tube
after the nose or mouth air passes into the
lungs
when initiating airway management on a patient the paramedic should
consider spinal precautions
to clear a pharynx of vomitus the paramedic should use a
tonsil tip catheter
the larynx sits immediately superior to the
trachea
which of the following would most likely cause severe upper airway edema
aggressive intubation
the average adult stomach can hold about
1.4 L
nasotracheal intubation is contraindicated if a patient has
head or nasal trauma
what would have the most dramatic effect on decreasing oxygenation of tissues?
blocked capillary flow in the lung
The phrenic nerve originates from which spinal nerves?
C3 - C4 - C5
What is an aspect of expiration?
Inactive during quiet respiration
What structure contains the chemoreceptors?
Arch of the aorta
When stretch receptors are stimulated by expansion of the lungs, information is conveyed to the medulla by which nerve?
Vagus
What structure contains the pneumotaxic center?
Pons
What is the major difference between the right mainstem bronchus and the left mainstem bronchus?
shorter
The intrathoracic pressure is normally _______.
Less than atmospheric pressure
Air normally moves into the lungs from the _______.
Pressure gradient created when the lungs expand
What is diffusion?
The movement of a gas from a higher pressure to a lower pressure across a semipermeable membrane
The normal movement of the diaphragm during inspiration _________.
Flattens the diaphragm
The ease with which the lungs expand during inspiration is known as what aspect?
Compliance
What is the function of pulmonary surfactant?
Lowers the surface tension, preventing alveolar collapse
Scalene and sternocleidomastoid muscles are normally used during what occurrence?
As accessory muscles during labored breathing
Which of the following is the most correct statement regarding physiologic dead space?
Increased in patients with respiratory diseases such as emphysema
Tidal volume is the amount of air _______.
Inhaled or exhaled during a normal breath
Minute volume is the amount of air _______.
In the tidal volume multiplied by the respiratory rate
A patient with a tidal volume of 500 mL, a dead space of 100 mL, and a respiratory rate of 10 breaths per minute has a minute alveolar ventilation of ______L per minute.
4
A hiccup results from the stimulation of which structure?
diaphragm
What gas is most prevalent in the atmosphere?
nitrogen
Blood in the pulmonary vein is ______.
high in oxygen
Which reading is a normal PO2?
80 - 100 mm Hg
Which reading is a normal PCO2?
65 mm Hg
Most of the oxygen in blood is carried ________.
Attached to hemoglobin
Which of the following is not a component of the alveolar wall?
Interstitial fluid
What is the most important factor in determining the extent to which oxygen combines with hemoglobin?
Partial pressure of oxygen in the blood plasma
Which is likely to decrease carbon dioxide production?
Resting quietly
The majority of carbon dioxide in the blood is carried ________.
As bicarbonate ion
What occurs as a result of hyperventilation?
Low carbon dioxide levels
What is the major determinant(s) in controlling respiration?
Partial pressure of carbon dioxide
A patient with chronic bronchitis is likely to rely on what mechanism to stimulate respiratory drive?
Hypoxia
A 45-year-old man chokes on a piece of steak during dinner; he is coughing forcefully. How should the paramedic continue?
Monitor the patient
What is the primary cause of airway obstruction in unconscious patients?
The tongue
The end tidal CO2 detector of an intubated patient in cardiac arrest does not change color. After visually confirming the tube passing through the vocal cords, what should the paramedic suspect?
There may be low cardiac output
A drop in systolic blood pressure of 10 mm Hg or more during inspiration is known as which occurrence?
Pulsus paradoxus
What is the transfer of oxygen and carbon dioxide between the capillary red blood cells and the tissue cells called?
Internal respiration
Which respiratory pattern is characterized by an irregular pattern, rate and volume, with intermittent periods of apnea?
biots
Which respiratory pattern is characterized by rapid,- regular respirations?
Central neurogenic hyperventilation
What is the component of the oxygen delivery system in which 50 psi oxygen is reduced to 30 psi oxygen for safe patient delivery?
Therapy regulator
What is the safe residual amount of oxygen a cylinder can contain when considered empty?
200 psi
What is an advantage of liquid oxygen (LOX) over gaseous oxygen?
A larger volume of LOX can be stored in a smaller space
The maximum acceptable flow rate for a nasal cannula is ___ L/min.
6
A nasal cannula delivers ____% oxygen at a flow rate of 6 L/min in optimal conditions.
44
The minimum oxygen flow rate for any face mask is ____ L/min.
4
Oxygen concentrations of ____ can be delivered using a simple face mask at a flow rate of 6 - 10 L/min.
35% - 60%
What is an advantage of a Venturi mask?
It can be used to deliver a precise concentration of oxygen
What is the most reliable indication that adequate tidal volumes are being delivered during artificial ventilation?
Adequate chest rise is observed
When delivering mouth-to-mask ventilations with supplemental oxygen, what should occur?
Provide a minimum flow rate of 10 to 12 L/min
The greatest difficulty in using a bag-mask device for ventilation is maintaining which aspect?
Adequate mask seal
What concentration of oxygen does a bag-mask device with a reservoir and an adequate oxygen source (at least 15 L/min) deliver?
100%
A bag-mask device for neonates, infants and children should include which aspect?
Have a minimum volume of 450 mL
Before a second attempt at intubation, a patient should be well ventilated with 100% oxygen for ____ to ____ seconds.
15, 30
In which position is the head and neck placed when using the sniffing position?
Flex the neck and extend the head
What is the maximum depth that a catheter should be inserted when suctioning a tracheotomy or stoma?
3 to 5 inches
To apply cricoid pressure, place firm pressure against which structure?
Cricoid cartilage
Automatic transport ventilators are typically contraindicated in which type of patients?
Under 5 years of age
A catheter that is flexible and designed to suction smaller portions of the airway or through an endotracheal tube is known as a _____ catheter.
Whistle-tip
In ideal circumstances, suctioning of an adult patient should not exceed ___ seconds.
10
Suctioning (application of negative pressure) should be activated during:
Extraction of the suction catheter
Placement of a nasogastric or orogastric tube is confirmed by which assessment aspect?
Auscultating over the epigastrium while injecting 30 to 50 mL of air
The nasopharyngeal airway should be measured from which point?
The tip of the nose to the earlobe
While inserting the nasal airway, the beveled tip should be directed toward which point?
Septum of the nose
Oropharyngeal airways are designed to perform which maneuver?
Prevent the tongue from obstructing the glottis
The endotracheal (ET) tube size refers to the ____ in millimeters.
Internal diameter
Cuffed ET tubes may be appropriate for children in what age group?
< 8 years old
When using a straight blade to intubate an adult patient, the tip of the blade should be placed in which location?
Directly on the epiglottis
Advocates of the curved blade claim which statement?
Provides more room for passage of the ET tube
When intubating an adult patient with a curved blade, the tip of the blade should be placed in which spot?
In the vallecula, at the base of the tongue
Which intubation technique may be performed without the use of specialized equipment?
Digital
The distal cuff of the ET tube should hold ____ mL of air.
5-10
Nasotracheal intubation would be the airway procedure of choice for which patient condition?
COPD
Phenylephrine spray is used during nasotracheal intubation to achieve which goal?
Constrict the blood vessels
Which is true of nasotracheal intubation?
Use a tube 1 to 1.5 sizes smaller than that used for orotracheal intubation
The laryngeal mask airway ________.
Generally protects against aspiration
What is a disadvantage of the laryngeal mask airway (LMA)?
Not all patients can be adequately ventilated with an LMA
The appropriate size i-gel for insertion in a patient who weighs 16 kg is:
2.0 gray
Which of the following is not a contraindication for placement of a King LT-D Airway?
A patient with GCS 7
What does capnography measure?
Carbon dioxide levels in exhaled air
If an endotracheal tube has been correctly placed, bulb esophageal detector devices will _____.
Re-inflate more easily
What does pulse oximetry measure?
Amount of hemoglobin saturated with oxygen
What is the correct anatomical landmark for a needle cricothyrotomy?
Cricothyroid membrane
What is the endotracheal tube size range used for cricothyrotomy?
6.0 to 7.0
Which is an anatomical difference in a child’s airway as compared to that of an adult?
The epiglottis is omega-shaped in a child
The approximation of the correct depth of insertion in centimeters for a 10-year-old child is ____ cm.
17
Lung sounds are heard after intubation only over the right lung of an adult patient. The endotracheal tube is at 27 cm at the teeth.
What is the most likely explanation for the findings in the intubation scenario?
Right mainstem intubation
Lung sounds are heard after intubation only over the right lung of an adult patient. The endotracheal tube is at 27 cm at the teeth.
Deflate the cuff and withdraw the tube 1 to 2 cm
When intubating using a lighted stylet, you see a dim, indistinct light in the throat. The paramedic has most likely intubated which structure?
Esophagus
You are treating a COPD patient and you note the following: BP 170/100 mm HG, P 50; ventilation assisted at 1 breath every 5 seconds; SaO2 not obtainable; etCO2 4 mm Hg after performing endotracheal intubation. What action should the paramedic take?
Decrease the rate of ventilation to 1 breath every 6 seconds
How do the drugs used in neuromuscular blockade cause paralysis?
Blocking the neuromuscular junction
What is the definition of depolarizing agents?
Substitute themselves for acetylcholine at the neuromuscular junction
Depolarizing agents have a ____ as compared to polarizing agents.
Quicker onset and shorter duration
An example of a depolarizing neuromuscular blocking drug is which drug?
Succinylcholine
Which of the following is not one of the six Ps of RSI?
Procedure
After the administration of succinylcholine, a patient is usually relaxed enough for intubation after _____.
45 seconds
