Airway and Ventilation Flashcard 3
Rationale
B. Rationale: Waveform capnography is recommended to confirm and monitor advanced airway placement.
Question
Colorimetric capnography is recommended to verify ET tube placement.
a. True
b. False
Answer
b. False
Rationale
D. Rationale: Confirmation of proper ET tube placement can be confirmed by physical examination (rise and fall of the chest, improvement of color, absence of breath sounds over the stomach), oxygen saturation, and quantitative waveform capnography. Chest X-ray can also be used to confirm placement. However, a chest X-ray for the patient in cardiac arrest is usually deferred until the patient has ROSC so as to not interrupt chest compressions.
Question
Confirmation that an ET tube is properly placed can be achieved by:
A. Observing visible rise and fall of the chest
B. Absence of auscultated breath sounds over the epigastrium
C. Quantitative waveform capnography
D. All of these
Answer
D. All of these
Rationale
B. Rationale: Suction catheters should not be advanced any further than the distance from the tip of the nose to the earlobe. Inserting beyond this distance may stimulate coughing and/or bronchospasm.
Question
Correct measurement when using a suction catheter involves measuring from:
A. The tip of the nose to the corner of the eye
B. The tip of the nose to the earlobe
C. The corner of the mouth to the earlobe
D. None of the above
Answer
B. The tip of the nose to the earlobe
Rationale
B. Rationale: Supplementary oxygen is recommended to be given at the highest setting to provide a maximal inspired oxygen dose.
Question
During CPR, positive pressure ventilation via bag-mask is being administered to a patient, with 2 ventilations for every 15 chest compressions. The bag-mask is connected to an oxygen supply. At what setting should you give supplementary oxygen?
a. Never at the highest setting
b. At the highest setting
c. Only if the patient has been in a drowning incident
d. Between 2 and 3 L/min
Answer
b. At the highest setting
Rationale
B. Rationale: It is important to avoid excessive ventilation. Excessive ventilation can lead to gastric inflation and possible aspiration of stomach contents. It can also increase intrathoracic pressure, decrease venous return to the heart, and decrease cardiac output.
Question
Excessive ventilation can be harmful because:
A. It can decrease intrathoracic pressure.
B. It can cause gastric inflation, causing the patient to vomit and aspirate into the lungs.
C. It can increase cardiac output.
D. It can increase venous return to the heart.
Answer
B. It can cause gastric inflation, causing the patient to vomit and aspirate into the lungs.
Rationale
A. Rationale: For a patient who is in respiratory arrest and has a pulse, provide 1 breath/ventilation every 6 seconds (10 breaths per minute) using a pocket mask, a bag-mask device, or another type of advanced airway.
Question
How often should you provide breaths/ventilations to an adult patient in respiratory arrest with a pulse?
A. 1 breath/ventilation every 6 seconds (10 breaths per minute)
B. 1 breath/ventilation every 3–5 seconds (12–20 breaths per minute)
C. 1 breath/ventilation every 5 seconds (12 breaths per minute)
D. The patient in respiratory arrest does not require ventilations, only chest compressions at a rate of at least 100 compressions/minute.
Answer
A. 1 breath/ventilation every 6 seconds (10 breaths per minute)
Rationale
D. Rationale: The goal of supplemental oxygen is to achieve an oxygen saturation between 94% and 99%.
Question
In ACLS, supplementary oxygen must be:
a. Continuously administered at an FiO2 of 100%
b. Monitored by quantitative waveform capnography
c. Delivered through an advanced airway
d. Titrated to achieve an oxygen saturation value ≥ 94%
Answer
d. Titrated to achieve an oxygen saturation value ≥ 94%
Rationale
B. Rationale: Use NPAs with extreme caution (or avoid altogether) in patients with facial trauma due to the possibility of the NPA entering the cranial cavity. NPAs can be used in conscious or semi-conscious patients, patients with trismus, patients with massive oral trauma, and when the patient’s jaws have been wired shut. They may also be used in the neurologically impaired with poor pharyngeal tone, which may lead to obstruction of the upper airway.
Question
In which of the following patients would you AVOID placing a nasopharyngeal airway (NPA)?
A. A patient with trismus
B. A patient who has suffered mid-face trauma
C. A patient who has had his jaw wired shut and is breathing inadequately
D. A patient who has suffered a stroke with upper airway obstruction
Answer
B. A patient who has suffered mid-face trauma
Rationale
A. Rationale: Each breath should be delivered over 1 second and should achieve visible chest rise.
Question
Over what period of time should each ventilatory breath be provided to the patient in respiratory arrest?
A. 1 second
B. 2 seconds
C. 3 seconds
D. 5 seconds
Answer
A. 1 second
Rationale
D. Rationale: Patients requiring assisted ventilation have respiratory rates < 6 breaths/minute.
Question
Patients requiring assisted ventilation have respiratory rates below:
a. 10 breaths/minute
b. 4 breaths/minute
c. 8 breaths/minute
d. 6 breaths/minute
Answer
d. 6 breaths/minute