Breathing Assessment and Oxygen Therapy - NREMT EMT Level

1. Which oxygen device is preferred for a breathing patient who requires high-concentration oxygen?

   Nonrebreather mask (NRB). It delivers up to 90-100% oxygen via a reservoir, ideal for hypoxemic patients needing maximal supplementation.

2. Which oxygen device is appropriate for a patient who needs supplemental oxygen but cannot tolerate a mask?

   Nasal cannula. It provides low-flow oxygen comfortably through nasal prongs for patients with claustrophobia or mask intolerance.

3. Which airway adjunct is indicated when a patient has an intact gag reflex but needs an adjunct?

   Nasopharyngeal airway (NPA). It bypasses the oral cavity to maintain patency without triggering gag in conscious or semi-conscious patients.

4. Which oxygen-delivery choice is best for a patient with severe dyspnea who is breathing at 28/min with shallow breaths?

   BVM-assisted ventilations with supplemental oxygen. Shallow, rapid breaths indicate impending failure, requiring assisted ventilation to improve tidal volume and oxygenation.

5. Which breath sound is most consistent with fluid in the lower airways or alveoli?

   Crackles (rales). Fluid accumulation disrupts air movement, creating bubbling sounds indicative of pulmonary edema or pneumonia.

6. Which breath sound is high-pitched and suggests upper-airway obstruction?

   Stridor. Partial blockage in the larynx or trachea generates turbulent inspiratory flow, signaling urgent intervention.

7. Which oxygen device is used to deliver humidified oxygen to a patient with a tracheostomy?

   Tracheostomy mask. It fits over the stoma to provide moist oxygen, preventing mucus drying and maintaining airway humidity.

8. What is the most reliable sign of adequate breathing in an adult during primary assessment?

   Adequate rate, depth, and regular pattern with good chest rise. These characteristics ensure sufficient tidal volume and oxygenation, reflecting effective respiratory function.

9. What is the normal adult respiratory rate range (breaths/min) used in EMT assessment?

   12–20 breaths/min. This range indicates normal ventilation in adults, allowing for adequate gas exchange without signs of distress or failure.

10. Which device is used to deliver a fixed, precise oxygen concentration for a breathing patient?

    Venturi mask. Adapters allow specific FiO2 settings by entraining room air, useful for COPD patients to avoid oxygen toxicity.

11. What oxygen flow rate range is typically used with a nasal cannula?

    1–6 L/min. This range delivers 24-44% FiO2, suitable for mild hypoxemia without causing discomfort or drying.

12. What does rapid breathing that exceeds metabolic needs indicate in EMT terminology?

    Hyperventilation. Excessive rate lowers CO2 levels, causing alkalosis and potential vasoconstriction or dizziness.

13. Which airway adjunct is indicated for an unconscious patient with no gag reflex?

    Oropharyngeal airway (OPA). It maintains tongue position to prevent airway obstruction in unresponsive patients lacking protective reflexes.

14. What oxygen flow rate is typically used for a nonrebreather mask to keep the reservoir inflated?

    10–15 L/min. This rate ensures the bag remains inflated, preventing room air entrainment and maintaining high FiO2.

15. What does absent or markedly diminished breath sounds on one side most strongly suggest?

    Pneumothorax (or severe unilateral obstruction). Unilateral reduction indicates air trapping or collapse, requiring immediate assessment for tension pneumothorax.

16. Which breath sound is most consistent with lower-airway narrowing as seen in asthma?

    Wheezing. Bronchoconstriction in conditions like asthma produces this sound during expiration due to turbulent airflow.

17. What is the normal infant respiratory rate range (breaths/min) commonly used in EMT assessment?

    25–50 breaths/min. Infants' immature respiratory systems and higher oxygen demands result in elevated baseline rates for effective gas exchange.

18. Identify the term for abnormally fast breathing rate.

    Tachypnea. It often compensates for hypoxia or metabolic acidosis but can lead to respiratory alkalosis if prolonged.

19. What is the preferred oxygen-delivery device for an apneic patient with a pulse?

    Bag-valve mask (BVM) with supplemental oxygen. It provides positive pressure ventilation to support oxygenation and ventilation in non-breathing patients with circulation.

20. What does shallow breathing with reduced tidal volume indicate in EMT terminology?

    Hypoventilation. Reduced tidal volume impairs gas exchange, causing hypercapnia and acidosis in affected patients.

21. Identify the term for abnormally slow breathing rate.

    Bradypnea. It reflects reduced respiratory drive or effort, leading to potential CO2 retention and hypoxemia.

22. What is the normal pediatric respiratory rate range (breaths/min) commonly used in EMT assessment?

    15–30 breaths/min. Children have higher metabolic rates, requiring faster breathing to maintain oxygenation and CO2 elimination.

23. Identify the best immediate action when SpO2 is low but the pulse oximeter waveform is poor.

    Troubleshoot probe/perfusion; reassess clinically before changing therapy. Poor waveform suggests inaccurate reading due to motion or poor perfusion, necessitating verification before intervention.

24. Which intervention is indicated for a breathing patient with inadequate tidal volume and poor chest rise?

    Assist ventilations with a BVM and supplemental oxygen. Positive pressure assists in increasing tidal volume and oxygenation when spontaneous efforts are insufficient.

25. What is the key difference between respiratory distress and respiratory failure?

    Failure has inadequate ventilation/oxygenation; distress still compensates. Distress involves compensatory mechanisms like tachypnea, while failure shows decompensation with hypoxia or altered mental status.

Study these flashcards