Airway Management & Ventilation 2
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- During a respiratory assessment, the absent of breath sounds may indicate?
- Pneumothorax
- The simplest airway management technique in a patient without suspected cervical spine injury is the?
- Head-tilt/chin lift maneuver
- Which manual airway maneuver should be used when caring for a patient with a suspected cervical spine injury?
- Modified jaw-thrust
- When a protion of the lung is unabailable for gas exchange, yet pulmonary circulation continues in that area of the lung, a condition known as ___ results?
- Ventilation-perfusion mismatch
- Anatomical dead space is the?
- Volume of air in the trachea, bronchi, and air passages containing air that does not reach the alveoli for gas exchange
- You should be prepared to immediatley intubate any patient with respiratory distress who is exhibiting?
- Altered mentation
- Which of the following basic airway adjuncts prevents the tongue from falling back to occlude the airway?
- Oropharyngeal airway
- The Sellick maneuver, applying posteriorly directed pressure on the cricoid cartilage?
- Minimizes gastric destention and facilitates placement of an endotracheal tube into the glottic opening
- A portable suction device should generate a flow rate of ___ liters per m inute when the tube is open?
- 30
- What is a contraindicition of insertion for a nasopharyngeal airway?
- facial fractures
- When a bag-valve ventilation device is used without supplemental oxygen, it delivers an oxygen concentration of ___ percent?
- 21
- An advantage of the two-person method of bag valve mask ventilation?
- Easier to maintain a seal between the patient's face and the mask
- The amount of gas moved in and out of the respiratory tract per minute?
- Minute Volume
- The amount of gas that remains in the respiratory system after forced expiration?
- Residual Volume
- The amount of gas inhaled or exhaled during a normal breath?
- Tidal Volume
- What pieces are necessary for insertion of an Esophageal Tracheal combiTube?
- Water soluble lubricant, Bag valve mask, & Suction equipment and a stethescope
- The patient with COPD may benefit from oxygen delivery through a Venturi mask because?
- Oxygen concentration is controlled more carefully
- The tip of the endotracheal tube for the pediatric patient should be inserted ___ cm below the vocal cords?
- 2-3
- A true statement about the use of dual lumen airway is?
- It requires no neck hyperextension
- The tip of a curved laryngoscope blade is placed correctly?
- In the vallecula
- The tip of a straight blade should be placed?
- Under the epiglottis
- With what condition should you NOT attempt an endotracheal intubation of a patient unless airway failure is imminent?
- Epiglottitis
- Name of drugs that can be given by tracheal route?
-
LEAN
Lidocaine, Epinephrine, Atropine, & Naloxone - An attempt at endotracheal intubation must not interrupt ventilations for more than ____ seconds?
- 30
- Indications of esophageal intubation?
- not seeing the tip of the endotracheal tube pass through the vocal cords
- Correct order of events after endotracheal tube has been properly inserted?
- Inflate the cuff w/ 5-10 cc of air, listen for equal breath sounds bilaterally, listen for breath sounds over the sipgastrium, secure the tube
- An ____ is an example of a dual lumen airway?
- CombiTube
- Insert the laryngoscope blade in the ____side of the mouth?
- Right
- Inset the endotracheal tube in the ___ side of the mouth?
- Right
- Sweep the tongue to the ___ side of the mouth?
- Left
- Visualize the structures by ____ them into alignment?
- Lifting
- By ___ you risk trauma to the teeth and other structures?
- Prying
- An adult patient who has been intubated due to respiratory arrest should be ventilated ____ times per minute?
- 15
- Immediate intubation should be considered for trauma patients with a Glasgow Coma Scale score of ___ or lower?
- 8
- During spontaneous breathing, which reflexes prevents overinflation of the lungs?
- Hering-Breuer
- What mechanism is responsible for hypoxemia in the patient with a pulmonary embolism?
- Pulmonary shunting
- What seres as an important visual landmark when performing endotracheal intubation under direct intubation?
- Arytenoid cartilage
- When intubating an adult patient, the onset of bradycardia is most likely due to?
- Stimulation of the vagus nerve
- Ventilation of ___ is the likely consequence of inserting an endotracheal tube too far?
- The right lung only
- The bifucation of the trachea is called the?
- Carina
- The internal respiration occurs in the?
- Peripheral capillaries
- At the end of exhalation, the intrathoracic pressure is?
- Equal to atmosperic pressure
- As the thoracic cavity begins to expand, the intrathoracic pressure?
- Is less than atmospheric pressure
- The normal partial pressure of oxygen is ___ mmHg?
- 80-100
- The movement of oxygen fro the alveoli to the blood in the pulmonary capillaries depends on?
- Diffusion of oxygen from an area of higher concentration to an area of lower concentration
- The respiratory rate may be greater than normal in?
- Acidosis due to an aspirin overdose
- The aspiration of vomitus into the lungs may result in?
- Tissue damage, pneumonia, & pulmonary adema
- In an adult, the narrowest part of the airway is the?
- Larynx
- Pulse oximetry approximates true oxygen saturation. T or F
- True
- Pulse oximetry provides a mean sof continuously evaluating oxygenation. T or F
- True
- Pulse oximetry is useful in assessing victims of carbon monoxide exposure. T or F
- False
- Pulse oximetry is a reliable tool in the evaluation of hypothermic patients. T or F
- False
- Patients with poor perfusing blood pressures can be rapidly and accurately assessed using pulse oximetry. T or F
- False
- End-tidal colorimetric capnography measures?
- Carbon dioxide in exhaled air
- An ___ may be used to facilitate nasotracheal intubation?
- Endotrol tube
- A properly placed ____ effectively isolates the trachea for ventilation and protection from aspiration?
- Endotracheal tube
- What contains thin epithelial linings and dense cappilary networks and are responsible for oxygen and carbon dioxide exchange?
- Alveoli
- Percutaneous route of medication administration?
- Sublingual, transdermal, & buccal
- An advantage of sublingual drug administration?
- Rapid absorption due to sublingual vasculature
- A disadvantage of pulmonary drug administration via nebulizer or metered dose inhaler?
- It requires that the patient have adequate ventilation
- A parenteral route of drug administration?
- Intramuscular
- A liquid preparation that contains small particles of medication is known as a?
- Suspension
- You notice absent breath sounds and gastric sounds with each ventilations. What should you do?
- Deflate the ET tube cuff, remove the ET tube, & hyperventilate the patient
- One teaspoon of medication equals ___mL?
- 5
- A plastic or glass container with a self-sealing rubber top is known as?
- Vial
- Into which container would it be necessary to inject a volume of air equal to the intended volume of medication before withdrawing the medication with a needle or syringe?
- Vial
- The appropriate administration for intradermal drug?
- 1 cc tuberculin syringe, 27 gauge 3/8" needle, or 25 gauge 1" needle
- Appropriate for a subcutaneous injection of medication?
- Vollume of medication of 1 mL or less
- Which route will medication have the quickest onset of action?
- Intramuscular
- The maximum volume of medication to be delivered into the deltoid muscle is ___mL?
- 2
- A site for central venous access?
- Femoral vein
- A site for peripheral venous access?
- Saphenous, External jugular, & median basilic
- What intravenous solution would remain in the vascular system the longest?
- Plasmanate
- What solution is appropriate for the patient needing vascular volume replacement in the prehospital setting?
- 0.9% sodium chloride solution
- Using microdrip IV tubing, how many drops of fluid equals 1 mL?
- 60
- What catheters would allow the greates volume of fluid to be delivered in a given period?
- 14 gauge 1 1/4"
- When preparing for venipuncture, a constricting band should be applied tight enough to restrict ____ flow and not left in place for more than ___ seconds?
- Venous but not arterial; 2
- Minor swelling around the venipuncture site, no discoloration, but it is cool and firm to the touch. What is your findings?
- Fluids extravasated into the tissue surrounding the IV site
- Anatomical wall dividing the nostrils?
- Septum
- Leaf-shaped, flexible cartilage that protects the larynx?
- Epiglottis
- Number of lobes in the right lung?
- Two
- Number of lobes in the left lung?
- Three
- Serous membrane covering the lung?
- Visceral
- Serous membrain lining the inside of the thoracic cavity?
- Parietal
- Protein that transports oxygen from the lungs to the body cells?
- Hemoglobin
- Primary method of transporting carbon dioxide in the body?
- Bicarbonate
- Clusters of air sacs that serve as the primary site for oxygen and carbon dioxide exchange?
- Alveoli
- Trangular-shaped cartilage structure that connects the pharynx with the trachea?
- Larynx
- The narrowest part of the adult airway?
- Glottis
- Hemoglobin is carried in the?
- Red blood cells
- Total lung capacity for the average adult male is approximately ____ L?
- 6
- Progressivley deeper, faster breathing alternating gradually with shallow, slower breathing is called?
- Cheyne-Stokes respirations
- The feeling of flexibitly or stiffness associated with the lungs and ventilation is?
- Compliance
- Excessive partial pressure of carbon dioxide i nthe blood?
- Hypercarbia
- Abbreviation for partial pressure of oxygen?
- PO2
- Insufficient oxygen in the blood?
- Hypoxemia
- oxygen saturation?
- SaO2
- Percentage of oxygen in inspired air?
- FiO2
- A bluish color of skin indicating respiratory distress?
- Cyanosis
- Excessively fast breathing?
- Tachypnea
- Excessively slow breathing?
- Bradypnea
- Normal quiet breathing?
- Eupnea
- The cessation of breathing?
- Apnea
- A misplacement of the ET tube identified by the skin bulging out on either side of the laryngeal prominence is called?
- Pyriform misplacement
- The purpose of using a malleable stylet during endotracheal intubation is to?
- Stiffen and maintain a pre-set curvve of the tube
- The amount of air filling the airway and unavailable for gas exchange?
- Dead space
- That amount of air that is actually exchanged?
- Alveolar
- Total lung capacity?
- Maximum lung capacity
- Measures the effectivness of bronchodilators?
- Peek expiratory flow
- Scarred lung due to COPD?
- Physiological dead space
- Most common indication for surgical cricothyrotomy is?
- Massive facial or neck trauma
- Atmospheric air contains ___% oxygen
- 21
- The absence or near absence of oxygen is called?
- Anoxia
- Nail polish could produce a false pulse oximetry reading. T or F
- True
- The % displayed is equal to the oxygen saturation of the blood. T or F
- False
- A pulse oximeter will interpret carbon monoxide as oxygen. T or F
- True
- Excessive environemental light may produce an unreliable reading in the pulse oximeter. T or F
- True
- The pulse oximeter may produce an unreliable reading in states of poor patient perfusion. T or F
- True
- Pulse oximeter is unaffected by the patient's temperature. T or F
- False
- The purpose of the cuff o nthe end of endotracheal tube is to?
- Seal the airway
- What is NOT required for blind nasotracheal intubation?
- A strong malleable stylet
- A pediatric patient larynx is funnel shaped. T or F
- True
- In a pediatric patient a greater degree of swelling is required before a significant airway obstruction will occur. T or F
- False
- In a pediatric patient the chest wall lacks rigidity. T or F
- True
- Pediatric patient rely more heavily upon the diaphragm for breathing. T or F
- True
- A pediatric patient larynx is more posterior. T or F
- False
- To optimize visualization of the larynx it is important?
- To lift the mandible
- When bag-valve ventilation device is used without supplemental oxygen, it delivers an oxygen concentration of ___%?
- 21