NREMT Respiratory Emergencies & Oxygen Delivery 1 — Questions and Answers

Question 1: What is a sign of respiratory distress?

Normal breathing rate.
Accessory muscle use and cyanosis (Correct answer)
Strong, clear speech.
Normal oxygen saturation.

Correct answer: Accessory muscle use and cyanosis

Signs of respiratory distress indicate that a patient is struggling to breathe and may not be getting enough oxygen. Accessory muscle use (e.g., in the neck and shoulders) shows increased effort to breathe, while cyanosis (bluish discoloration of skin/mucous membranes) indicates severe oxygen deprivation. These are critical signs requiring immediate intervention to improve oxygenation.

Question 2: What is the appropriate device for a patient with adequate breathing but low oxygen saturation?

Bag-valve-mask (BVM).
Nasal cannula or non-rebreather mask (Correct answer)
Simple face mask.
Ventilator.

Correct answer: Nasal cannula or non-rebreather mask

For a patient with adequate breathing but low oxygen saturation, supplemental oxygen is needed. A nasal cannula delivers low-flow oxygen for mild hypoxia, while a non-rebreather mask delivers high concentrations of oxygen for more significant hypoxia. Both devices assist the patient's own breathing efforts to improve oxygen levels without requiring ventilatory assistance.

Question 3: What condition causes wheezing and difficulty exhaling?

Asthma (Correct answer)
Pulmonary edema.
Pneumothorax.
Pulmonary embolism.

Correct answer: Asthma

Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways, leading to bronchospasm. This narrowing makes it difficult to exhale, producing the characteristic high-pitched whistling sound known as wheezing. Patients often experience shortness of breath, chest tightness, and coughing during an asthma exacerbation.

Question 4: What is the oxygen concentration delivered by a non-rebreather mask?

21%.
40–60%.
90–100% (Correct answer)
100–120%.

Correct answer: 90–100%

A non-rebreather mask is designed to deliver the highest possible concentration of supplemental oxygen to a spontaneously breathing patient, typically 90-100%. It achieves this by having a reservoir bag that fills with oxygen and one-way valves that prevent exhaled air from mixing with the oxygen in the bag, ensuring the patient inhales nearly pure oxygen.

Question 5: When is a BVM indicated?

Adequate breathing.
Inadequate or absent breathing (Correct answer)
Low heart rate.
Mild shortness of breath.

Correct answer: Inadequate or absent breathing

A bag-valve-mask (BVM) is indicated for patients who have inadequate breathing (e.g., very slow, shallow, or irregular breaths) or are not breathing at all (apnea). The BVM allows EMS providers to manually assist or provide ventilations, ensuring the patient receives sufficient oxygen and ventilation to sustain life. It is a critical tool for respiratory arrest.

Question 6: What is a common cause of crackles in the lungs?

Asthma.
Pulmonary edema (Correct answer)
Pneumothorax.
Anxiety attack.

Correct answer: Pulmonary edema

Crackles, also known as rales, are abnormal lung sounds often described as crackling or bubbling. They are commonly caused by pulmonary edema, a condition where fluid accumulates in the air sacs and airways of the lungs, typically due to heart failure. The sounds occur as air passes through the fluid-filled alveoli and small airways.

Question 7: What is the preferred oxygen delivery for a COPD patient with low oxygen levels?

Non-rebreather mask.
Bag-valve-mask (BVM).
Nasal cannula (Correct answer)
Ventilator.

Correct answer: Nasal cannula

For COPD patients with low oxygen levels, a nasal cannula is generally the preferred oxygen delivery method because it provides controlled, low-flow oxygen. Administering high concentrations of oxygen via a non-rebreather mask can suppress the hypoxic drive in some COPD patients, potentially leading to respiratory depression. The goal is to improve oxygenation without compromising their respiratory drive.

Question 8: What is the oxygen flow rate for a nasal cannula?

1–6 L/min (Correct answer)
6–10 L/min.
10–15 L/min.
15–20 L/min.

Correct answer: 1–6 L/min

A nasal cannula is designed for low-flow oxygen delivery, typically set at a flow rate between 1 and 6 liters per minute (L/min). This range provides supplemental oxygen concentrations of approximately 24% to 44%, suitable for patients with mild to moderate hypoxia who are breathing adequately. Higher flow rates with a nasal cannula can be uncomfortable and less effective.

Question 9: What should you do if a conscious adult is choking?

Start chest compressions.
Give water to drink.
Perform abdominal thrusts (Correct answer)
Call hospital immediately.

Correct answer: Perform abdominal thrusts

Perform abdominal thrusts (Heimlich maneuver) until the object is expelled or the patient becomes unresponsive.

NREMT Respiratory Emergencies & Oxygen Delivery 1

What is a sign of respiratory distress?