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FISDAP Paramedic Airway and Breathing Exam V2.
What relaxes bronchial smooth muscles? - ANSWERbeta agonists A 47-year old male complains of chest discomfort and difficulty breathing. He has had a fever, chills, and a productive cough for 3 days. Crackles are present upon auscultation. What is the most likely cause? - ANSWERBacterial Pneumonia A 45 year old male was assaulted and you note a small, localized area on the chest that is edematous. You hear crackling when the skin palpated. What should you expect? - ANSWERSubcutaneous Emphysema While ventilating an intubated patient, you notice a shark fin waveform on capnography. Ventilations become increasingly difficult. What should you do?
- ANSWERAdminister albuterol A 28 year old female is complaining of gradual-onset dyspnea after being released from the hospital. She was hospitalized for 1 day following thoracic trauma and a lung contusion. Lung sounds present with crackles in both bases. Vital signs are BP 130/80, P 110, R 32 shallow, SpO2:88%. You should - ANSWERapply oxygen via non-rebreather and transport emergently What is the volume of air that a patient inhales during each breath referred to as? - ANSWERTidal Volume When you hear wheezing, where is the obstruction located? - ANSWERLower Airway
a 68 year old female complains of shortness of breath and is sitting in a tripod position and has pink sputum in the corners of her mouth. Vital signs are BP 165/110, P88, R22 with crackles, SpO2 82% on 3lpm. What should you do? - ANSWERIncrease oxygen A 71 year old mle with a tracheostomy tube is cyanotic. You hear audible gurgling during inspiration and crackles in the base of the lungs. Vital signs are BP 148/100, P 94, R 24, SpO2 88%. What should you do? - ANSWERSuction the lumen with a soft tip catheter A 19 year old male was extricated from a structure fire. He is actively coughing and complains of pain due to burns on his chest, arms and stomach. What is the priority? - ANSWERLaryngeal swelling a 62 year old female complains of shortness of breath. She is sitting upright in bed with multiple pillows behind her back. She has history of COPD and diabetes. Skin is warm to the touch. BP 166/100, P 84 irregular, R 20 with crackles, SpO2 95%. What should you do? - ANSWERAdminister 2.5mg of Albuterol A 29 year old male inhaled an unknown chemical. His voice is now horse and its difficult to understand him. Vital signs P136, R28, SpO2 78%. What should you do? - ANSWERPlace the patient on a nasal cannula and lie the patient supine A 56 year old female is sitting upright in bed on a home CPAP machine. She is unable to follow verbal commands and is lethargic. What should you do? - ANSWERAssist ventilations with a bag mask device.
What structure in the brain controls ventilations? - ANSWERMedulla What is the location of the bifurcation in the trachea? - ANSWERCarina A 84 year old male is in respiratory arrest after pulling out his tracheostomy tube. You feel air leaking around the bag-valve mask when ventilating through the stoma. No chest rise is noted. What should you do? - ANSWERReposition head and attempt ventilation A 51 year old male with history of COPD is having difficulty breathing. Vital signs are BP 158/74, P 100, R 22, SpO2 86%. What should you do? - ANSWERAdminister oxygen by non-rebreather mask While transporting an intubated patient, it is becoming increasingly difficult to assist ventilations. What should you suspect? - ANSWERDeflated cuff A 23 year old male was snowmobiling without a helmet when he was hit in the throat and knocked from his vehicle. He is unresponsive and your partner is unable to ventilate him with a BVM. You are unable to visualize the vocal chords. What should you do? - ANSWERPerform a needle cricothyrotomy A 31 year old female was trampled by a horse. She is unresponsive and you are unable to ventilate after multiple attempts. Upon direct visualization, the vocal cords are unrecognizable. What should you do? - ANSWERPerform a needle cricothyrotomy
A 21 year old female is unresponsive. Her jaw is clenched and she has rapid, shallow respirations. Her mouth and nose are covered in wet vomitus. What should you do? - ANSWERPlace in a lateral recumbent position You find an awake 63 year old thin male with barrel chest and pink skin. What disease process should you suspect? - ANSWEREmphysema Which of the following procedures can lead to aspiration? - ANSWERBag Mask Ventilation What is the name of the tracheal cartilage that sits directly inferior to the larynx? - ANSWERCricoid Which of the following is an objective finding that confirms successful intubation? - ANSWEREnd tidal carbon dioxide waveform A 72 year old female has shortness of breath. She is on 2 lpm nasal cannula and has had 2 nebulizer treatments for her emphysema. Her initial ETCO was 46 mmHg. During your reassessment, she is unable to follow simple commands and her ETCO2 is 60 mmHg. What should you do? - ANSWERAssist her breathing with a bag-mask device An intubated 18 year old male is in respiratory arrest. At what range should you maintain his EtCO2? - ANSWER 35 - 45 mmHg What is the normal tidal volume in an adult male? - ANSWER500mL
A ventilator dependent patient's SpO2 level decreases from 94% to 80%. You hear coarse, wet sounds coming from the ET tube. What should you do? - ANSWERPerform deep tracheal suctioning Where does the stimulus to breathe come from? - ANSWERBrainstem A 22 year old female is apneic. You have been attempting to place the ET tube for the past 30 seconds without success. Vital signs are P 46, SpO2 67%. What should you do? - ANSWERStop and assist ventilations with a BVM A 72 year old male complains of sudden onset of pain in his upper right chest. He states he recently had hernia surgery. Vital signs are BP 140/80, P 102, R
- What is the most likely cause? - ANSWERPulmonary Embolism A 68 year old female is supine in bed and responds only to painful stimuli. Vital signs are BP 108/64, P 52, R 6 and shallow, SpO2 78%. What should you do? - ANSWERAssist ventilations with aa bag-valve mask What is the name of the smooth, moist epithelial layer that covers the lungs?
- ANSWERVisceral pleura After attempting ventilations of both ports of a dual lumen airway device, you are unable to see chest rise and fall. What should you do? - ANSWERRemove the device and re-oxygenate The air that we exhale contains approximately how much oxygen? - ANSWER16%
An unresponsive patient has a tracheostomy tube. How should you assist ventilations? - ANSWERUse an adult BVM with a pediatric mask and ventilate through the stoma An adult patient was short of breath with a productive cough with yellowish- green secretions. He is now apneic and lung compliance is poor after endotracheal intubation. What should you do? - ANSWERPerform tracheal suctioning What is the correct dosage of ipratropium bromide during an asthma attack?
- ANSWER0.5 mg, by nebulizer What is alveolar collapse known as? - ANSWERAtelectasis A 45 year old female awoke in the middle of the night. She complains of breathing difficulties. Her medications are HCTZ, digoxin and Coumadin. Vitals are BP 180/104, P 102 and irregular, R 28 with bilateral crackles. What is the most likely cause? - ANSWERPulmonary Edema You administered a short acting paralytic and are unable to successfully intubate the patient after two attempts. Vital signs are P 50, SpO2 86%. What should you do? - ANSWERInsert an oral airway and ventilate with a BVM A 49 year old female is clutching her throat and whispers "I can't breathe". What should you do? - ANSWEREncourage her to cough A 24 year old female was stung by a bee and now is short of breath. Vital signs are BP 88/40, P 120, R 26 with wheezing. What should you administer? - ANSWEREpinephrine IM
Which of the following patients is at greatest risk of aspiration? - ANSWERA 20 year old intoxicated male who is responsive to pain While providing ventilations to a patient you are unable to see chest rise. What should you do? - ANSWERReposition the patient's head A 82 year old male complains of difficulty breathing. He is receiving a continuous nebulizer treatment. Nursing home staff state he has had increasing dyspnea today with wheezing and a non-productive cough. Vital signs are BP 136/82, P 122, R 28, SpO2 89%, skin is pink warm and dry. What should you suspect? - ANSWEREmphysema What results from hyperventilating a patient? - ANSWERInhibited preload and hypotension A very large man in restaurant is clutching his throat and unable to speak. You are unable to reach your arms around his abdomen. What should you do? - ANSWEREncourage him to cough A patient is in status asthmaticus. Initial treatments and medications are ineffective. You note use of accessory muscles to breathe. Vital signs are SpO2 70%, ETCO2 55 mmHg. What should you do? - ANSWERPrepare for intubation What is the semi-stiff, cartilage-containing flap of tissue covering the opening of the trachea? - ANSWEREpiglottis
You are transporting a chemically sedated male who is ventilator dependent and he becomes cyanotic. ETCO2 decreases from 33 mmHg to 10 mmHg. Vital signs are BP 88/40, P 56, R assisted. What should you suspect? - ANSWERDislodge endotracheal tube An anxious 55 year old female complains of shortness of breath and swelling in her right leg. She is diaphoretic. Vital signs are P 124 and weak, R 22, SpO 91%. What should you suspect? - ANSWERPulmonary Embolism
