Breathing Assessment and Oxygen Therapy
Help Questions
NREMT: EMT Level › Breathing Assessment and Oxygen Therapy
Which oxygen flow rate is appropriate when using a nasal cannula?
1-6 liters per minute to deliver 24-44% oxygen concentration
10-15 liters per minute to deliver 85-100% oxygen concentration
6-10 liters per minute to deliver 35-60% oxygen concentration
15-25 liters per minute to deliver maximum oxygen saturation
Explanation
Nasal cannula operates at 1-6 LPM delivering 24-44% oxygen. Higher flow rates cause patient discomfort and don't significantly increase oxygen delivery. Option B describes simple face mask flows. Option C describes non-rebreather mask flows. Option D exceeds safe nasal cannula parameters.
When using a non-rebreather mask, what is the minimum oxygen flow rate required to prevent carbon dioxide rebreathing?
12 liters per minute to achieve maximum oxygen concentration delivery
8 liters per minute to ensure proper mask seal and function
6 liters per minute to maintain adequate reservoir bag inflation
10 liters per minute to keep reservoir bag inflated during inspiration
Explanation
Non-rebreather masks require minimum 10 LPM to keep the reservoir bag inflated and prevent CO2 rebreathing. Lower flow rates (options A and B) allow bag collapse and CO2 rebreathing. While 12 LPM (option D) is acceptable, 10 LPM is the minimum required.
Which finding during breathing assessment indicates the need for immediate positive pressure ventilation?
Patient speaking in short sentences due to mild dyspnea
Patient using accessory muscles but maintaining adequate oxygen saturation
Respiratory rate of 6 breaths per minute with weak chest rise
Respiratory rate of 24 breaths per minute with good tidal volume
Explanation
Bradypnea (6 breaths/minute) with weak chest rise indicates inadequate minute ventilation requiring BVM. Option A shows tachypnea but adequate breathing. Option B shows mild distress with adequate breathing. Option D shows increased work of breathing but still adequate ventilation.
What is the most appropriate oxygen therapy for this patient?
Non-rebreather mask at 10-15 liters per minute for potential anaphylaxis
Bag-valve-mask ventilation to assist with increased respiratory effort
Simple face mask at 6-8 liters per minute for moderate dyspnea
Nasal cannula at 2-4 liters per minute for mild respiratory distress
Explanation
Bee sting with dyspnea suggests possible allergic reaction/anaphylaxis requiring high-concentration oxygen via non-rebreather mask. Nasal cannula (option A) provides insufficient oxygen for potential anaphylaxis. BVM (option C) is inappropriate for adequate breathing. Simple face mask (option D) provides lower oxygen concentration than needed for this emergency.
What is the most reliable method to assess breathing adequacy in an unconscious patient?
Observe skin color changes and monitor for cyanosis development
Look for chest rise and fall, listen for air movement, feel for breath
Listen for breath sounds using stethoscope on both sides of chest
Check pulse oximetry reading and monitor for oxygen saturation trends
Explanation
The look-listen-feel method provides comprehensive assessment of breathing adequacy by evaluating chest movement, air exchange, and breath sensation. Auscultation (option A) alone doesn't assess rate or depth. Pulse oximetry (option C) can be delayed or inaccurate. Skin color (option D) is a late sign of respiratory compromise.
What oxygen delivery method is most appropriate for this patient?
Nasal cannula at 2-4 liters per minute for comfort measures
Non-rebreather mask at 10-15 liters per minute for chest pain protocol
No oxygen therapy needed since patient is speaking normally
Bag-valve-mask assistance to reduce respiratory workload
Explanation
Chest pain patients receive high-concentration oxygen via non-rebreather mask regardless of apparent breathing adequacy, as this may indicate cardiac ischemia. Option A ignores chest pain protocol. Nasal cannula (option B) provides insufficient oxygen for potential cardiac event. BVM (option D) is inappropriate for adequate breathing.
When should you suspect inadequate breathing in a patient who appears to be breathing?
Patient is able to speak but uses short, choppy sentences
Patient appears anxious and requests to sit in upright position
Respiratory rate is slightly elevated at 22 breaths per minute
Chest rise is barely visible and skin shows cyanotic discoloration
Explanation
Barely visible chest rise with cyanosis indicates inadequate tidal volume and poor oxygenation. Slight tachypnea (option A) may be normal. Short sentences (option B) suggest distress but may still indicate adequate breathing. Anxiety and positioning preference (option D) are compensatory but don't necessarily indicate inadequate breathing.
What is the correct ventilation rate when providing bag-valve-mask ventilation to an adult patient?
10-12 breaths per minute to maintain normal physiologic ventilation
8-10 breaths per minute to avoid hyperventilation complications
20-24 breaths per minute to compensate for poor tidal volume
12-20 breaths per minute to match normal respiratory rate
Explanation
BVM ventilation for adults should be 10-12 breaths per minute (one breath every 5-6 seconds). Option A is too slow and may cause hypoxia. Option C matches spontaneous breathing but is too fast for positive pressure ventilation. Option D risks hyperventilation and decreased cardiac output.
When using a bag-valve-mask, what indicates you are providing effective ventilation?
Visible chest rise and fall with each ventilation at appropriate rate
Maximum bag compression to deliver largest possible tidal volume safely
Rapid chest compressions with maximum pressure delivery technique
Fast ventilation rate to quickly improve patient's oxygen saturation levels
Explanation
Effective BVM ventilation is indicated by visible chest rise and fall at the appropriate rate (10-12/min for adults). Option A describes chest compressions, not ventilation. Option C risks hyperventilation. Option D can cause gastric distension and lung injury.
What is your immediate action regarding this patient's breathing?
Begin immediate bag-valve-mask ventilation with high-flow oxygen delivery
Apply nasal cannula oxygen and monitor respiratory pattern development closely
Coach patient to breathe more regularly and deeply with verbal encouragement
Position patient in recovery position and provide supplemental oxygen therapy
Explanation
Agonal respirations are inadequate and indicate impending respiratory arrest requiring immediate BVM ventilation. Nasal cannula (option A) won't help inadequate breathing. Recovery position (option B) is inappropriate for someone needing ventilation assistance. The patient is unconscious and cannot respond to coaching (option D).