Airway

While assessing the respiratory function of an ill five-year-old child, you note the presence of inspiratory stridor, even though the patient appears to have adequate oxygenation. Since the stridulous respirations are inspiratory only, what area of the child's respiratory system do you suspect the adventitious breath sounds are originating?

• Within the right or left bronchus

• Within the alveoli

• in the upper airway immediately above the glottic opening

• just superior to the carina in the lower airway

When performing endotracheal intubation on an adult patient who is apneic, which of the following is the next step taken by the paramedic after inflating the cuff of the ET tube?

• Secure the ET tube in place

• Auscultate over the epigastric region

• Ensure breath sounds are present and equal on either side of the chest

• Attach a bag-valve mask with an EtCO2 detector and attempt ventilations

If a paramedic is using a disposable colorimetric device to ensure the endotracheal tube is properly placed in the trachea, what color would indicate the tube is properly placed in the trachea?

• Yellow

• Purple

• White

• Brown

You are on scene with a patient in respiratory arrest. After intubating the patient using the endotracheal route, you note the presence of adequate breath sounds on the right side, but you auscultate decreased breath sounds on the left side of the patient's chest.

What should you do at this point in the intervention?

• Further inflate the cuff to ensure that air is not leaking around the tube and back up into the trachea, then reassess for breath sounds.

• Deflate the cuff, retreat the ET tube 2-3 cm, reinflate the cuff and reassess for breath sounds

• Deflate the cuff, pull the ET tube out completely and inspect for defects before inserting and reassessing for breath sounds

• Deflate the cuff, advance the ET tube 1-2 cm, reinflate the cuff, and reassess for breath sounds

While assessing the respiratory effort of a non-intubated adult COPD patient using capnography, you note the presence of a shark fin waveform on the monitor. Which of the following is most likely the cause of this finding?

• Bronchospasm

• Vasoconstriction

• Laryngeal spasm

• Hyperventilation

In rare cases, intubation will be required to manage the airway of a patient suffering from a severe asthma attack. Immediate intubation should always be initiated in asthma patients who are apneic and should be considered at other times. Which of the following conditions should cause the paramedic to consider intubating an asthma patient?

• Patient does not respond to bronchodilator therapy and is conscious

• Patient is in known respiratory alkalosis

• Patient's PCO2 is less than 50 mmHG

• Patient's PO2 is less than 50 mm Hg

Which of the following effectively measures the amount of carbon dioxide in a patient's exhaled air?

• EtCO2

• CPAP

• PEEP

• SpCO2

You are orally intubating a patient experiencing spasmodic closure of the vocal cords from laryngeal spasm. What is the best way to get the cords to allow the passage of the ET tube in this situation?

• Apply steady cricoid pressure throughout the intubation

• Apply copious lubrication to the vocal cords and ET tube

• Allow the tip of the stylet to exit the end of the tube to serve as a guide through the narrow opening

• A forceful upward pull of the jaw to reposition the airwar

Which of the following airway devices are indicated for patients who depend on hypoxic drive to breathe?

• Venturi mask

• Nasal cannula

• Simple face mask

• Non-rebreather mask

When using a laryngeal mask airway (LMA), how does the paramedic know when the device is successfully inserted?

• When the tube cannot be advance any farther

• When you visualize the tube passing through the vocal cords

• When the 21-centimeter mark on the tube is located at the patient's chin

• When the cuff is inflated, the LMA will move slightly upward ~0.5-0.75 inches