A patient experiences cardiac arrest, and the resuscitation team initiates ventilations
using a bag-valve-mask (BVM) resuscitator. The development of which condition
during the provision of care would lead the team to suspect that improper BVM
technique is being used?
Hypertension
Esophageal injury
Pneumothorax
Rib fracture - correct answers.Pneumothorax
Complications can occur with the use of a BVM resuscitator due to improper
technique. Delivering excessive volume or ventilating too fast creates excessive
pressure that can damage the airways, lungs and other organs. Excessive volume
can lead to tension pneumothorax.
A person suddenly collapses while sitting in the sunroom of a healthcare facility. A
healthcare provider observes the event and hurries over to assess the situation. The
healthcare provider performs which assessment first?
Rapid assessment
Basic life support assessment
Secondary assessment
Primary assessment - correct answers.Rapid assessment
A systematic approach to assessment is necessary. The healthcare provider should
first perform a rapid assessment. A rapid assessment is a visual survey to ensure
safety, form an initial impression about the patient's condition (including looking for
life-threatening bleeding), and determine the need for additional resources. This
would be followed by a primary assessment and then a secondary assessment.
A patient is receiving ventilation support via bag-valve-mask (BVM) resuscitator.
Capnography is established and a blood gas is obtained to evaluate the adequacy of
the ventilations. Which arterial carbon dioxide (PaCO2) value signifies adequate
ventilations?
,10 to 15 mmHg
20 to 25 mmHg
25 to 30 mmHg
35 to 45 mmHg - correct answers.35 to 45 mmHg
Arterial carbon dioxide (PaCO2) values in the range of 35 to 45 mmHg confirm
adequacy of ventilation.
A resuscitation team is debriefing following a recent event. A patient experienced
cardiac arrest, and advanced life support was initiated. The patient required the
placement of an advanced airway to maintain airway patency. Which statement
indicates that the team performed high-quality CPR?
"We initiated chest compressions at a rate of 100 to 110 per minute to a depth of 2.4
inches and then gave 1 ventilation every 10 seconds."
"We provided chest compressions at a rate of 100 to 120 compressions per minute
while giving 1 ventilation every 6 seconds without pausing compressions."
"We provided chest compressions at a rate of 80 to 120 per minute to a depth of at
least 2 inches and gave 1 ventilation every 6 seconds without pausing
compressions."
"We kept the rate of chest compressions to around 100 per minute but adjusted their
depth to 1.5 inches while giving 1 ventilation every 3 seconds without pausing
compression - correct answers."We provided chest compressions at a rate of 100 to
120 compressions per minute while giving 1 ventilation every 6 seconds without
pausing compressions."
When an advanced airway has been placed in a patient who is in cardiac arrest,
compressions should be delivered continuously (100 to 120 per minute) with no
pauses for ventilations.
Assessment of a patient reveals an ETCO2 level of 55 mmHg and an arterial oxygen
saturation (SaO2) level of 88%. The provider would interpret these findings as
indicative of which condition?
Respiratory failure
Respiratory arrest
Cardiac arrest
Respiratory distress - correct answers.Respiratory failure
An SaO2 level of less than 90% (PaO2 of less than 50 mmHg) accompanied by
ETCO2 values greater than 50 mmHg is indicative of respiratory failure.
A responsive patient is choking. What method should the provider use first to clear
the obstructed airway?
Back blows
Abdominal thrusts
Magill forceps extraction
Chest compressions - correct answers.Back blows
, To clear an obstructed airway in a responsive adult, first provide up to 5 back blows
to clear the obstruction.
A patient arrives at the emergency department complaining of shortness of breath.
The patient has a long history of chronic obstructive pulmonary disease. Assessment
reveals respiratory failure. Which action would be the initial priority to address the
respiratory failure?
Establishment of vascular access
Delivery of supplemental oxygen via nasal cannula
Assisted ventilation with BVM resuscitator
Initiation of capnography - correct answers.Assisted ventilation with BVM
resuscitator
Patients who cannot ventilate adequately despite an open airway or who have
insufficient respiratory effort require assisted ventilation initially provided via a BVM
resuscitator.
A 20-year-old man with respiratory depression is brought to the emergency
department by his parents. Opioid overdose is suspected, and an initial dose of
naloxone is administered at 10 p.m. The patient does not respond to this initial dose.
The team would expect to administer a second dose after how many minutes?
2 minutes
4 minutes
6 minutes
8 minutes - correct answers.2 minutes
The dose of naloxone may be repeated after 2 to 3 minutes.
Assessment of a patient in the emergency department reveals that the patient is
experiencing respiratory compromise. From the assessment, the team identifies that
the patient is in the earliest stage of this condition. Which stage would this be?
Respiratory distress
Respiratory failure
Respiratory arrest
Respiratory acidosis - correct answers.Respiratory distress
Respiratory compromise occurs along a continuum, beginning with respiratory
distress, progressing to respiratory failure and then to respiratory arrest.
The following capnogram is from a patient experiencing respiratory distress. At which
point in the waveform would the patient's ETCO2 level be measured?
B
C
D
E - correct answers.D