CH 9: Respiration and Artificial Ventilation - Critical Thinking Flashcards

1
Q

On arrival at the emergency scene, you find and adult female patient who is semiconscious. Her respiratory rate is 7/min. She appears pale and slightly blue around her lips. What immediate actions are necessary? Is this patient in respiratory failure, and if so what signs and symptoms indicate this? Does this patient require artificial ventilations?

A

After assuring scene is safe, EMT should open this patient’s airway and if necessary, support with airway adjunct. Her altered mental status, slow respiratory rate and cyanosis all point to respiratory failure. This patient needs immediate respiratory assistance with a bag valve mask and supplemental oxygen.

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2
Q

On arrival at the scene, you find an adult male patient sitting bolt upright in his chair. He looks at you as you come into the room but is unable to speak more than two words at a time. He seems to have a prolonged expiratory phase; you hear wheezes and his respiratory rate is 36. What immediate actions are necessary? Is this patient in respiratory failure and if so what signs and sypmtoms indicate this? Does this patient require artificial ventilations?

A

At minimum this patient needs supplemental oxygen. Further assessment will be necessary to identify respiratory failure. If your assessment identifies further indications of respiratory failure then immediate artificial ventilation is necessary.

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3
Q

You find an adult female patient pacing outside her damaged vehicle. She appears to be breathing very rapidly but acknowledges you as you approach. Her color seems normal and her respiratory rate is 48. What immediate actions are necessary? Is this patient in respiratory failure and if so what signs and symptoms indicate this? Does this patient require artificial ventilation?

A

Although this patient may just be anxious after the motor-vehicle crash, a thorough assessment must be completed to assure the fast rate is not due to an injury. Rapid respiratory rates can indicate inadequate breathing, but further assessment will be necessary to identify respiratory failure.

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4
Q

Describe the elements you would assess to determine if a patient is breathing adequately.

A

To identify respiratory failure, boty oxygenation and ventilation must be assessed. Mental status, skin color and pulse oximetry can all be used to assess oxygenation. Listening to lung sounds, observing respiratory effort and looking for accessory muscle use help assess ventilation. If no deficits in oxygenation or ventilation are noted during these assessments the patient is breathing adequately. Any deficits with either element point to inadequate breathing and respiratory failure.

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5
Q

You are assessing a breathing patient. Describe what findings might indicate the need to initiate artificial ventilations despite the fact the patient continues to breathe.

A

A breathing patient may need artificial ventilation if his breathing is deemed to be inadequate. Signs include altered mental status, cyanosis, slowing or irregular respirations and respiratory fatigue.

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6
Q

Describe how you would determine that you have delivered enough air (volume) when ventilating using a bag-valve mask.

A

When using a bag-valve mask, watch for chest rise to assure adequate volume.

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