Airway and Ventilation Flashcard 1
Rationale
C. Rationale: Performing the head tilt-chin lift or jaw-thrust maneuvers aim to keep the airway in the neutral position so that the tongue and tissues of the palate move away from the posterior wall of the pharynx.
Question
A structure that may obstruct the airway is the:
a. Glottis
b. Larynx
c. Tongue
d. Thyroid cartilage
Answer
c. Tongue
Rationale
A. Rationale: If the rescuer is following all the procedures for administering ventilations, and the patient does not improve, suspect a likely upper airway obstruction if there is no visible chest rise. In this instance, an airway adjunct or a more invasive procedure such as endotracheal intubation is necessary.
Question
After ensuring that ventilations are being done correctly by the rescuer for a patient in respiratory arrest, you do not observe a chest rise. What is your conclusion in this situation?
a. There is a significant upper airway obstruction.
b. Chest rise is not usually observed in pediatric patients even if adequate air volume is delivered.
c. This patient must have a congenital heart disease.
d. The patient likely has a concomitant pulmonary infection
Answer
a. There is a significant upper airway obstruction.
Rationale
A. Rationale: Passive ventilation is performed by allowing full chest recoil, producing negative intrathoracic pressure to move oxygen from the environment into the lungs. This is performed by opening the airway with an oropharyngeal airway and oxygen supplementation via a face mask.
Question
How does one provide passive ventilation?
a. Allowing full chest recoil
b. Bag-mask ventilation
c. Mouth-to-mouth resuscitation
d. Head tilt-chin lift maneuver
Answer
a. Allowing full chest recoil
Rationale
B. Rationale: The head tilt-chin lift maneuver is recommended, especially for single rescuers who may need to provide chest compressions and positive pressure ventilation. However, the rescuer should not use this maneuver in patients that may have trauma to the spine because it involves extending the neck, which can worsen any fractures that might be present.
Question
If the rescuer has no reason to suspect trauma in an unconscious patient, the preferred method to open the pediatric airway is the:
a. Jaw-thrust maneuver
b. Head tilt-chin lift maneuver
c. Recovery position
d. Abdominal thrust position
Answer
b. Head tilt-chin lift maneuver
Rationale
B. Rationale: Perform the jaw-thrust maneuver in trauma patients where vertebral fractures may be suspected. Also, use the jaw-thrust maneuver when performing assisted ventilations using a bag-valve-mask device.
Question
In an unconscious patient after a trauma with a possible fracture, the best way for the rescuer to open the airway while protecting the cervical vertebrae is the:
a. Chin-lift maneuver
b. Jaw-thrust maneuver
c. Back blow maneuver
d. Abdominal thrust maneuver
Answer
b. Jaw-thrust maneuver
Rationale
B. Rationale: The nasopharyngeal airway is made of silicone. Because of its flexibility, conscious patients with an intact gag or coughing reflex can tolerate the airway. The oropharyngeal airway is a rigid device that can stimulate coughing and gagging and should only be used in unconscious patients with no cough or gag reflex.
Question
Of the following airway adjuncts, the one used in a conscious patient is the:
a. Oropharyngeal airway
b. Nasopharyngeal airway
c. Endotracheal tube
d. Any of the above
Answer
b. Nasopharyngeal airway
Rationale
B. Rationale: Excessive ventilations can increase the risk of morbidity and mortality. It can cause an increase in intrathoracic pressure, leading to reduced venous return, pulmonary perfusion, cardiac output, and coronary perfusion pressures. Thus, excessive ventilation must be avoided.
Question
What is an effect of providing excessive positive pressure ventilations to a patient in cardiac arrest?
a. Can improve tissue hypoxia
b. Can cause abdominal distention with an increase in intrathoracic pressure
c. Eliminates rescuer fatigue
d. Can cardiovert ventricular fibrillation
Answer
b. Can cause abdominal distention with an increase in intrathoracic pressure
Rationale
D. Rationale: Effective bag-mask ventilation must ensure a properly fitting mask. The mask must completely cover the patient’s mouth and nose without covering the eyes or overlapping the chin.
Question
When applying a face mask for bag-mask ventilation, how would you ensure that it is placed correctly on the patient?
a. Only use a circular mask in pediatric patients to ensure it fits.
b. You may use any mask as they are one size fits all.
c. Ensure that the mask overlaps the patient’s nose, mouth, and eyes.
d. The mask completely covers the nose and mouth of the patient.
Answer
d. The mask completely covers the nose and mouth of the patient.
Rationale
A. Rationale: The jaw-thrust maneuver is recommended for any patient when suspecting spinal trauma because it does not involve extending the neck, which can worsen any fractures that may be present.
Question
When attempting to open the airway of an unconscious pediatric patient after a traumatic injury, the preferred method to use is:
a. Jaw-thrust maneuver
b. Head tilt-chin lift maneuver
c. Recovery position
d. Abdominal thrust position
Answer
a. Jaw-thrust maneuver
Rationale
D. Rationale: Give each breath over 1 second, which should be enough to produce an observable chest rise. If the rescuer continues to give deeper breaths after achieving chest rise, a pneumothorax may develop. On the other hand, if there is no visible chest rise, then the upper airway may be obstructed, or the rescuer needs to provide more volume.
Question
When delivering air to a pediatric patient, the rescuer knows the volume is sufficient when they see:
a. Good oxygen saturation
b. Increasing pulse rate
c. Skin changes from bluish to a pinkish color
d. Visible chest rise
Answer
d. Visible chest rise