Prehospital Emergency Care Ch. 10
Practice Questions
What structure divides the airway into upper and lower? -
The larynx is the division between the upper and lower airway.
The cartilaginous flap of tissue that protects the opening to the trachea is called the -
Epiglottis
What type of muscle constricts in the lower airways in conditions such as asthma and
anaphylaxis? -
Smooth muscle surrounds these airways and is responsible for constriction.
How does care differ for a patient who is snoring versus a patient who has a gurgling noise in
the airway? -
Snoring indicates a physical obstruction - most likely the tongue - which can be
cleared by a head-tilt, chin lift or jaw thrust maneuver. Gurgling indicates foreign material or
secretions in the airway which require suction.
List three indications that you should use a jaw thrust instead of a head-tilt, chin lift. -
A mechanism of injury indicating cervical injury, a complaint of pain in the neck,
physical findings of injury to the neck, or injury to the head or shoulders that could also
involve the cervical spine.
How do you measure an oral airway? -
Measure from the center of the mouth to the angle of the jaw or from the corner of
the mouth to the tip of the ear.
How do you measure a nasal airway? -
Nasal airways are measured from the nostril to the tip of the ear lobe or the angle of
the jaw.
What standard precautions should be taken prior to suctioning? -
You should wear gloves and also protect your face. Facial protection includes eye
wear and a mask or a face shield.
A 20 French catheter is (larger or smaller) than a 22 French catheter? -
The 20 French catheter is smaller. The larger the number, the larger the catheter.
What is the difference between respiratory distress and respiratory failure? -
Respiratory distress is a feeling of shortness of breath and may include an increased
work of breathing. In respiratory distress breathing is still adequate. Respiratory failure is
when oxygen intake is inadequate to support life. Identifying the difference between
respiratory distress and failure is critical for the EMT.
Hypercapnea -
Elevated levels of carbon dioxide
1|Page
,What two components are necessary for adequate breathing? -
Rate and depth must both be adequate for a patient to breathe adequately. The rate
must not be too slow or too fast and the depth must be sufficient to move air past the dead air
space and into the alveoli.
What is the most common upper airway obstruction? -
The tongue. In cases of altered mental status, the muscles that control the tongue
lose tone and allow the tongue to fall back in the throat when supine.
Bronchoconstricion -
Narrowing of the airways--specifically the bronchioles.
What type of muscle is responsible for bronchoconstriction? -
Smooth muscle in the bronchioles is responsible for bronchoconstriction.
Is cyanosis an early or late sign of hypoxia? -
Cyanosis is a late sign indicating significant hypoxia. You will usually see increased
respiratory rate and pulse, anxiety and other signs first.
You observe an EMT providing respirations rapidly and too forcefully. The result of this
would be: -
Air will be forced into the stomach which can cause gastric insufflation and
vomiting. It can also lower the patient's carbon dioxide levels which can cause cerebral
vasoconstriction and reduce blood flow to the brain.
What EMS devices utilize positive pressure ventilation? -
The most commonly used devices are the BVM and the pocket face mask. Positive
pressure ventilators (sometimes called FROPVD or demand valves) and transport ventilators
also use positive pressure.
CPAP stands for -
Continuous Positive Airway Pressure
How do you determine how much oxygen to give a patient? -
There are many factors to consider including: pulse oximetry reading, skin color,
mental status, the patient's complaint, vitals, history, and more. Of course you must first be
sure the patient does not require ventilation (respiratory arrest, respiratory failure).
What are the visceral and parietal pleura? -
The visceral pleura covers the lungs. The parietal pleura is attached to the chest
wall. The pleural space (or pleural cavity) is a small, fluid-filled space between these two
layers. It is a vital component of respiration and chest expansion. When a patient has a
pneumothorax, air accumulates in the pleural space.
When providing suction, how does one make sure that the machine provides suction only on
the way out of the mouth? -
The hole on the catheter is covered with a thumb or finger when the EMT wants to
apply suction. There is no suction until the hole is covered.
2|Page
, What is the carina? -
The carina is the point where the trachea bifurcates into the left and right mainstem
bronchi.
You are called to a 74-year-old man who is experiencing chest discomfort and mild shortness
of breath. He is oriented and has vital signs that appear to be within normal limits. The pulse
oximeter reads 96%. Would you administer oxygen to this patient? If so, how much? -
This patient would not receive oxygen. With only minor distress, normal vitals and
an oxygen saturation of 96% this patient would not receive any oxygen, unless his oxygen
saturation continue to drop below 94%.
Your respiratory arrest patient has vomited profusely. You begin to suction. How long should
you suction before providing a ventilation? -
You should suction quickly and efficiently until the airway is clear, in 15 second
increments. Then provide ventilations.
Your 3-year-old patient was found in the backyard pool and is unresponsive. A carotid pulse
is present at 60 beats per minute. Breathing is shallow at six per minute. You should
immediately:
a. begin rescue breathing.
b. begin chest compressions.
c. apply a non-rebreather mask.
d. place the patient in the recovery position -
a) begin rescue breathing.
EXPLANATION According to 2015 American Heart Association Guidelines, the appropriate
treatment would be to provide rescue breathing at 1 breath every 3-5 seconds, or about 12-20
breaths/min. Add compressions if pulse remains at or below 60/min with signs of poor
perfusion.
Hypercapnea is defined as:
a. elevated levels of carbon monoxide.
b. elevated levels of oxygen.
c. elevated levels of hemoglobin.
d. elevated levels of carbon dioxide. -
d. elevated levels of carbon dioxide
A responsive 18 month-old female swallowed a marble and is cyanotic. You should:
a. administer oxygen via pediatric NRB
b. perform CPR
c. perform back blows and chest thrusts
d. deliver abdominal thrusts -
d. deliver abdominal thrusts
What chemical produced in the lungs prevents the collapse of the alveoli by reducing the
surface tension?
a. Surfactant
b. Hemoglobin
c. Mucolipid
d. Atrovent -
Surfactant
3|Page
Practice Questions
What structure divides the airway into upper and lower? -
The larynx is the division between the upper and lower airway.
The cartilaginous flap of tissue that protects the opening to the trachea is called the -
Epiglottis
What type of muscle constricts in the lower airways in conditions such as asthma and
anaphylaxis? -
Smooth muscle surrounds these airways and is responsible for constriction.
How does care differ for a patient who is snoring versus a patient who has a gurgling noise in
the airway? -
Snoring indicates a physical obstruction - most likely the tongue - which can be
cleared by a head-tilt, chin lift or jaw thrust maneuver. Gurgling indicates foreign material or
secretions in the airway which require suction.
List three indications that you should use a jaw thrust instead of a head-tilt, chin lift. -
A mechanism of injury indicating cervical injury, a complaint of pain in the neck,
physical findings of injury to the neck, or injury to the head or shoulders that could also
involve the cervical spine.
How do you measure an oral airway? -
Measure from the center of the mouth to the angle of the jaw or from the corner of
the mouth to the tip of the ear.
How do you measure a nasal airway? -
Nasal airways are measured from the nostril to the tip of the ear lobe or the angle of
the jaw.
What standard precautions should be taken prior to suctioning? -
You should wear gloves and also protect your face. Facial protection includes eye
wear and a mask or a face shield.
A 20 French catheter is (larger or smaller) than a 22 French catheter? -
The 20 French catheter is smaller. The larger the number, the larger the catheter.
What is the difference between respiratory distress and respiratory failure? -
Respiratory distress is a feeling of shortness of breath and may include an increased
work of breathing. In respiratory distress breathing is still adequate. Respiratory failure is
when oxygen intake is inadequate to support life. Identifying the difference between
respiratory distress and failure is critical for the EMT.
Hypercapnea -
Elevated levels of carbon dioxide
1|Page
,What two components are necessary for adequate breathing? -
Rate and depth must both be adequate for a patient to breathe adequately. The rate
must not be too slow or too fast and the depth must be sufficient to move air past the dead air
space and into the alveoli.
What is the most common upper airway obstruction? -
The tongue. In cases of altered mental status, the muscles that control the tongue
lose tone and allow the tongue to fall back in the throat when supine.
Bronchoconstricion -
Narrowing of the airways--specifically the bronchioles.
What type of muscle is responsible for bronchoconstriction? -
Smooth muscle in the bronchioles is responsible for bronchoconstriction.
Is cyanosis an early or late sign of hypoxia? -
Cyanosis is a late sign indicating significant hypoxia. You will usually see increased
respiratory rate and pulse, anxiety and other signs first.
You observe an EMT providing respirations rapidly and too forcefully. The result of this
would be: -
Air will be forced into the stomach which can cause gastric insufflation and
vomiting. It can also lower the patient's carbon dioxide levels which can cause cerebral
vasoconstriction and reduce blood flow to the brain.
What EMS devices utilize positive pressure ventilation? -
The most commonly used devices are the BVM and the pocket face mask. Positive
pressure ventilators (sometimes called FROPVD or demand valves) and transport ventilators
also use positive pressure.
CPAP stands for -
Continuous Positive Airway Pressure
How do you determine how much oxygen to give a patient? -
There are many factors to consider including: pulse oximetry reading, skin color,
mental status, the patient's complaint, vitals, history, and more. Of course you must first be
sure the patient does not require ventilation (respiratory arrest, respiratory failure).
What are the visceral and parietal pleura? -
The visceral pleura covers the lungs. The parietal pleura is attached to the chest
wall. The pleural space (or pleural cavity) is a small, fluid-filled space between these two
layers. It is a vital component of respiration and chest expansion. When a patient has a
pneumothorax, air accumulates in the pleural space.
When providing suction, how does one make sure that the machine provides suction only on
the way out of the mouth? -
The hole on the catheter is covered with a thumb or finger when the EMT wants to
apply suction. There is no suction until the hole is covered.
2|Page
, What is the carina? -
The carina is the point where the trachea bifurcates into the left and right mainstem
bronchi.
You are called to a 74-year-old man who is experiencing chest discomfort and mild shortness
of breath. He is oriented and has vital signs that appear to be within normal limits. The pulse
oximeter reads 96%. Would you administer oxygen to this patient? If so, how much? -
This patient would not receive oxygen. With only minor distress, normal vitals and
an oxygen saturation of 96% this patient would not receive any oxygen, unless his oxygen
saturation continue to drop below 94%.
Your respiratory arrest patient has vomited profusely. You begin to suction. How long should
you suction before providing a ventilation? -
You should suction quickly and efficiently until the airway is clear, in 15 second
increments. Then provide ventilations.
Your 3-year-old patient was found in the backyard pool and is unresponsive. A carotid pulse
is present at 60 beats per minute. Breathing is shallow at six per minute. You should
immediately:
a. begin rescue breathing.
b. begin chest compressions.
c. apply a non-rebreather mask.
d. place the patient in the recovery position -
a) begin rescue breathing.
EXPLANATION According to 2015 American Heart Association Guidelines, the appropriate
treatment would be to provide rescue breathing at 1 breath every 3-5 seconds, or about 12-20
breaths/min. Add compressions if pulse remains at or below 60/min with signs of poor
perfusion.
Hypercapnea is defined as:
a. elevated levels of carbon monoxide.
b. elevated levels of oxygen.
c. elevated levels of hemoglobin.
d. elevated levels of carbon dioxide. -
d. elevated levels of carbon dioxide
A responsive 18 month-old female swallowed a marble and is cyanotic. You should:
a. administer oxygen via pediatric NRB
b. perform CPR
c. perform back blows and chest thrusts
d. deliver abdominal thrusts -
d. deliver abdominal thrusts
What chemical produced in the lungs prevents the collapse of the alveoli by reducing the
surface tension?
a. Surfactant
b. Hemoglobin
c. Mucolipid
d. Atrovent -
Surfactant
3|Page
