Respirarory BLS/ALS Standards

Question 1

Oxygen Therapy Standards

The paramedic shall;
continuously administer high concentration oxygen for patients who have… (6)

Answer 1

a. confirmed or suspected carbon monoxide or cyanide toxicity or noxious gas
exposure,
b. upper airway burns,
c. scuba-diving-related disorders,
d. ongoing cardiopulmonary arrest,
e. complete airway obstruction, and/or
f. sickle cell anemia with suspected vaso-occlusive crisis;

Question 2

Oxygen therapy standards

If pulse oximetry equipment is not functioning or not providing an interpretable wave
form, administer high concentration oxygen to all patients specified in paragraph 2 above,
as well as those with critical findings, which include, (5)

Answer 2

a. age-specific hypotension,
b. respiratory distress,
c. cyanosis, ashen colour, pallor,
d. altered level of consciousness, and/or
e. abnormal pregnancy or labour.

Question 3

Oxygen Therapy Standards

What oxygen saturation shall the paramedic attempt to achieve in a patient with COPD?

Answer 3

88-92%

Question 4

Shortness of Breath Standard

List acute respiratory disorders that may be a cause of SOB (8)

Answer 4

i. partial airway obstruction,
ii. asthma,
iii. anaphylaxis,
iv. aspiration,
v. inhalation of toxic gases or smoke,
vi. pneumothorax,
vii. COPD, and
viii. respiratory infections,

Question 5

Shortness of Breath Standard

List acute cardiovascular disorders that may be a cause of SOB (4)

Answer 5

i. acute coronary syndrome/acute myocardial infarction (e.g. STEMI),
ii. congestive heart failure,
iii. pulmonary edema, and
iv. pulmonary embolism,

Question 6

Shortness of Breath Standard

LIst other causes that may contribute to SOB (3)

Answer 6

i. cerebrovascular accident,
ii. toxicological effects, and
iii. metabolic acidosis;

Question 7

Respiratory Failure Standard

In patients with COPD or Asthma who have an initial ETCO2 of >50mmhg attempt to maintain ETCO2 between …

Answer 7

50-60mmHg

Question 8

Acute Cardiogenic Pulmonary Edema Medical DIrective

Indications

Answer 8

Moderate to severe respiratory distress

AND

Suspected Cardiogenic pulmonary edema

Question 9

Acute Cardiogenic Pulmonary Edema Medical DIrective

Conditions

Answer 9

> /= 18years
HR: 60-159bpm
SBP: Normotension

Question 10

Acute Cardiogenic Pulmonary Edema Medical DIrective

Contraindications

Answer 10

1. Allergy or sensitivity to nitrates
2. phosphodiesterase inhibitor use within the previous 48hrs
3. SBP drops more than 1/3 of initial value after nitro is administered

Question 11

Bronchoconstriction Medical Directive

Indications

Answer 11

Respiratory Distress
AND
Suspected bronchoconstriction

Question 12

Croup Medical Directive

Indications (4)

Answer 12

Severe respiratory distress
AND
Stridor at rest
AND
Current history of URTI
AND
Barking cough or recent hx of a barking cough

Question 13

Croup Medical Directive

Conditions

Answer 13

Age - <8 years

HR <200bpm

Question 14

Croup Medical Directive

Treatment

Answer 14

Question 15

Acute Cardiogenic Pulmonary Edema Medica Directive

Treatment

Answer 15

Question 16

What are the suctioning pressures for Infants, Pediatrics, and Adults?

Answer 16

<1 year - 60-100mmHg
>1 year to < 12 years - 100-120mmhg
>12 years - 100-150mmHg