Paramedic Module 2 Part 2

The normal respiratory rate for an adult at rest is 12 to 20 breaths per minute. This range is considered normal because it indicates that the person's breathing is within a healthy and typical range. A respiratory rate lower than 12 or higher than 20 could be a sign of an underlying health issue or abnormality. Therefore, a respiratory rate of 12 to 20 is considered the standard for an adult at rest.

The oropharyngeal airway is an airway adjunct that is used to displace the tongue forward in order to maintain an open airway. It is inserted into the mouth and extends from the lips to the back of the throat, effectively preventing the tongue from obstructing the airway. This device is commonly used during CPR or in unconscious patients to ensure proper ventilation and oxygenation. The other options, such as the PtL airway, endotracheal tube, and nasopharyngeal airway, do not primarily displace the tongue forward to maintain an open airway.

The nasopharyngeal airway does not stimulate the gag reflex as strongly compared to the oropharyngeal airway. This is an advantage because it allows for easier insertion and provides better patient comfort. The reduced stimulation of the gag reflex also reduces the risk of vomiting and aspiration during airway management. Additionally, the nasopharyngeal airway can be used with a bag-valve-mask (BVM) device, providing effective ventilation support.

High inspired oxygen concentrations do not cause reduced inspiratory volumes. In fact, they can actually increase inspiratory volumes by providing more oxygen to the body. Pneumothorax, asthma, respiratory muscle paralysis, and emphysema can all cause reduced inspiratory volumes due to various reasons such as airway obstruction, lung damage, or muscle weakness.

Paradoxical breathing is a breathing pattern associated with flail chest. Flail chest occurs when multiple ribs are fractured in multiple places, causing a segment of the chest wall to become detached from the rest of the thoracic cage. This results in paradoxical movement of the affected segment during respiration, meaning that instead of expanding during inhalation and contracting during exhalation, it moves in the opposite direction. This abnormal breathing pattern is a characteristic feature of flail chest and can be observed during physical examination.

Capnography is a valuable tool in assessing various aspects of patient care. It can assess the effectiveness of CPR by measuring the levels of carbon dioxide in exhaled breath, which indicates the adequacy of chest compressions. It can also help in determining the proper initial endotracheal tube placement by monitoring the waveform and numeric values of carbon dioxide. Additionally, capnography can assess the continuing proper endotracheal tube placement during ongoing ventilation. Lastly, it can provide information about patient responses to medications by monitoring changes in carbon dioxide levels. Therefore, the correct answer is "all of the above."

The straight laryngoscope blade is considered to be the best designed for intubation of infants because it provides better visualization of the infant's airway. The straight blade allows for easier insertion and positioning of the endotracheal tube, reducing the risk of injury to delicate structures in the infant's throat. Additionally, the straight blade is more suitable for infants with limited neck mobility, as it requires less manipulation to achieve proper alignment. Overall, the straight laryngoscope blade is preferred for intubation of infants due to its superior functionality and safety.

Compliance refers to the ability of the lungs and chest wall to expand and contract easily. It is a measure of the flexibility or stiffness of the respiratory system. A high compliance means that the lungs and chest wall are easily expandable, allowing for efficient ventilation. On the other hand, a low compliance indicates stiffness, making it difficult for the lungs to expand and contract properly. Therefore, compliance is the most suitable term to describe the feeling of flexibility or stiffness associated with the lungs and ventilation.

Endotracheal intubation is the preferred airway technique for an unconscious patient because it provides a secure airway and allows for effective ventilation and oxygenation. It involves placing a tube through the mouth or nose into the trachea to bypass any obstructions in the upper airway. This technique ensures that the patient receives adequate oxygen and prevents aspiration of fluids or foreign objects into the lungs. Oropharyngeal and nasopharyngeal airways are not as effective in providing a secure airway for unconscious patients, and nasotracheal intubation is not typically recommended due to the risk of complications.

Severe epiglottitis is not an indication for endotracheal intubation because it is a condition where the epiglottis, a small flap of cartilage that covers the windpipe, becomes inflamed and swollen. Intubation may worsen the swelling and potentially obstruct the airway further. Instead, the preferred treatment for severe epiglottitis is immediate medical attention, which may involve medications to reduce the swelling or a surgical procedure to alleviate the obstruction.

The normal partial pressure of CO2 in exhaled air is 38 mmHg. This is because during respiration, oxygen is taken in and carbon dioxide is released as a waste product. The partial pressure of CO2 in the alveoli of the lungs is higher than in the blood, causing CO2 to diffuse from the blood into the alveoli and eventually be exhaled. The average partial pressure of CO2 in the alveoli is around 40 mmHg, and as exhaled air mixes with residual air in the airways, it decreases slightly to around 38 mmHg.

A colormetric device is a disposable device that records the level of exhaled CO2 using PH sensitive chemically impregnated paper. This device changes color based on the level of CO2 present in the exhaled breath, providing a visual indication of the CO2 level. It is a simple and cost-effective method for measuring CO2 levels and is commonly used in medical settings for monitoring ventilation during procedures.

Sighing is a modified form of respiration that is designed to expand alveoli that may have collapsed during periods of inactivity or rest. During sighing, a deep breath is taken, followed by a prolonged and forceful exhale. This helps to re-inflate the alveoli and improve lung function.

The absence of CO2 in exhaled air, as identified by the end expiratory CO2 detector, suggests that the endo tube may be in the esophagus. This is because when the endo tube is correctly placed in the trachea, CO2 from the lungs is expelled during exhalation and can be detected. However, if the endo tube is mistakenly inserted into the esophagus, no CO2 will be detected in the exhaled air, indicating an incorrect placement of the tube.

The correct answer is "directly along the floor of the nasal cavity." When inserting a nasopharyngeal airway, the soft rubber tube is directed along the floor of the nasal cavity. This is done to ensure proper placement of the airway and to avoid any damage to the nasal structures. Inserting the tube along the floor of the nasal cavity helps to bypass the nasal turbinates and reach the nasopharynx effectively.

Central neurogenic hyperventilation is characterized by deep and rapid respirations. This pattern occurs due to dysfunction in the brainstem, specifically the respiratory centers. The brainstem is responsible for regulating breathing, and when there is a disruption in this area, it can lead to abnormal breathing patterns. Central neurogenic hyperventilation is often seen in patients with brainstem lesions or damage. This explanation aligns with the given correct answer.

Stridor is a high-pitched, wheezing sound that occurs during breathing and is most commonly associated with laryngeal constriction or edema. However, in this case, the correct answer is central neurogenic hyperventilation. Central neurogenic hyperventilation is a pattern of breathing characterized by rapid and deep breaths, and it is often associated with dysfunction in the brainstem. This dysfunction can lead to an increased respiratory drive and result in stridor. Therefore, central neurogenic hyperventilation is the most likely cause of stridor in this scenario.

Stridor is a high-pitched, wheezing sound that occurs during breathing and is typically caused by a blockage or narrowing of the airway. It is commonly associated with fluids within the airway, such as mucus or secretions, which can obstruct the flow of air and cause the characteristic sound. This can occur in conditions like croup, where inflammation and swelling of the airway lining lead to increased mucus production. It is important to identify and address the underlying cause of the fluid accumulation to alleviate the stridor and ensure proper breathing.