PLATINUM FINAL EXAM EMTP 3.3 REVIEW 2023 QUESTIONS AND ANSWERS COMPLETE

PLATINUM FINAL EXAM EMTP 3.3 REVIEW 2023 QUESTIONS AND ANSWERS COMPLETE What is the best airway device to use for smoke inhalation? Endotracheal intubation is frequently needed for supportive therapy in the management of inhalation injury. Most pertinent piece of information in evaluating a patient's ventilatory status? Ventilation is the movement of air in and out of the lungs through a patent airway. The majority of observations regarding ventilation focus on the movements of the chest. SIGNS OF ADEQUATE VENTILATION: In most patients, your assessment of ventilation will be based on observing their respiratory rate (normal 12 to 20) and listening for clear breathing sounds in the left and right chest. Auditory confirmation of breathing sounds is the strongest sign of adequate ventilation. In patients on ventilators or bag-valve-mask, this does not change. Most pertinent piece of information in evaluating a patient's oxygenation status? Oxygenation is the delivery of oxygen to the tissues of the body, poor ventilation or respiration will generally lead to poor oxygenation. Loss of oxygenation is the ultimate result of ventilatory or respiratory failure. You need to observe the patient's mental status, skin color, oral mucosa, and check a pulse oximeter. Mental status is either normal or abnormal, assessing mental status is based on asking questions about who the person is, what time/date it is, where they are, and why they are here. Skin and mucosal color are important indicators of oxygenation. Just as with poor respiration, cyanosis, pallor, or mottling are signs of decreased oxygen delivery. Pulse oximetry level is the most objective measure of oxygenation, it reads the saturation of hemoglobin (reported as SPO2), note that a pulse oximeter is not foolproof. A patient with poor oxygenation in the limbs may have sufficient oxygenation to their core or vise-versa. Pulse oximeters can also be fooled by specific toxic gases. Always ensure that you match up your pulse oximetry readings with physical findings and ensure they support one another. Pulse oximeters are imperfect and are not a real-time measure of O2 saturation Most important assessment in evaluating a patient's oxygen delivery to the brain? Prior to applying supplemental oxygen, objective data regarding patient status should quickly be obtained such as airway patency, respiratory rate, pulse oximetry, and lung sounds. Signs of cyanosis in the skin or nail bed assessment should also be noted. What is the next step to take if a patient's breathing does not improve with an NRB? BVM What is the next step to take after opening the airway of an unresponsive patient with slow, shallow respirations? After manually opening an unconscious patient's airway, you should: check the mouth for secretions, foreign bodies, or dentures. If clear, then started manually ventilating! Know your ventilation rates Adult: 12-20/minute Child: 15-30/minute Infant: 25-50/minute Flow rates for 02 devices: Nasal Cannula - 2-6L/min Nebulizer - 6-8L/min Non-ReBreather - 10-15L/min BMV - 15L/min EndoTracheal Tube - 15L/min King LTS-D - 15L/min CPAP - 25L/min (oxygen port) When to use what airway device given a scenario / When to use what ventilation device given a scenario: ET Tube One intubation attempt with the definitive airway on patients in cardiac arrest before a provider can attempt placement of a supraglottic airway (King Airway). If the first attempt fails, the provider may attempt at intubation again, or elect to place the King Airway or return to the BLS airway (BVM). When to use what airway device given a scenario / When to use what ventilation device given a scenario: King LT These devices are best used when the ET Tube does not work. When to use what airway device given a scenario / When to use what ventilation device given a scenario: LMA / iGel It is secured in the throat via the inflation cuff, although the seal of the LMA is not as effective as that of an ETT. An iGel works the same way, and does not have an inflatable cuff. These devices are best used when the ET Tube does not work. When to use what airway device given a scenario / When to use what ventilation device given a scenario: CPAP Used for patients with CHF, or drowning victims. Used to help get fluid out of the lungs that is signified by crackles or rales. Must meet requirements of blood pressure and consciousness to be used. Can have a nebulizer connected if the situation requires it. When to use what airway device given a scenario / When to use what ventilation device given a scenario: Nasal Cannula Used for minimal oxygen for patients that have a lower SPO2 than 95% When to use what airway device given a scenario / When to use what ventilation device given a scenario: Non-Rebreather Used for patients that require more than 6L of oxygen, and can be used with a nebulizer for maximum efficiency. When to use what airway device given a scenario / When to use what ventilation device given a scenario: BVM BLS airway that is used initially before an advanced airway, and connected to one if one is placed.