Paramedics Exam Airway, Respiration, and Ventilation 5 — Questions and Answers
Question 1: A 6-year-old child in respiratory arrest requires BVM ventilation. What is the appropriate ventilation rate?
- 8-10 breaths/min
- 10-12 breaths/min
- 12-20 breaths/min (Correct answer)
- 20-30 breaths/min
Correct answer: 12-20 breaths/min
Children (1 year to puberty) without an advanced airway should be ventilated at 12-20 breaths per minute when they have a pulse but are apneic.
Question 2: Kussmaul respirations are characterized by:
- Slow, shallow breathing with long pauses
- Deep, rapid, labored breathing without pauses (Correct answer)
- Alternating periods of apnea and hyperpnea
- Irregular, gasping breaths
Correct answer: Deep, rapid, labored breathing without pauses
Kussmaul respirations are deep, rapid, and labored — a physiologic response to severe metabolic acidosis, classically seen in diabetic ketoacidosis.
Question 3: A tension pneumothorax is BEST decompressed in the prehospital setting by:
- Applying a three-sided occlusive dressing
- Needle thoracostomy at the 2nd intercostal space, midclavicular line (Correct answer)
- Immediate chest tube placement at the 5th ICS
- Positive pressure ventilation with high FiO2
Correct answer: Needle thoracostomy at the 2nd intercostal space, midclavicular line
Needle thoracostomy (needle decompression) at the 2nd ICS midclavicular line is the standard prehospital treatment for tension pneumothorax.
Question 4: Which of the following is NOT a sign of adequate ventilation during BVM use?
- Visible chest rise and fall
- SpO2 improving toward normal
- Audible gurgling over the epigastrium (Correct answer)
- EtCO2 waveform present
Correct answer: Audible gurgling over the epigastrium
Gurgling over the epigastrium indicates air is entering the stomach, not the lungs — this signals improper ventilation and risk of aspiration.
Question 5: A patient is experiencing an anaphylactic reaction with severe bronchospasm and stridor. After epinephrine, the NEXT airway intervention is:
- Oral intubation with RSI before swelling worsens (Correct answer)
- Nasal cannula oxygen at 6 L/min
- Applying a nonrebreather mask only
- Waiting to see if epinephrine resolves the swelling
Correct answer: Oral intubation with RSI before swelling worsens
Rapidly progressing anaphylaxis with stridor requires early definitive airway management (RSI/intubation) before further swelling makes intubation impossible.
Question 6: The normal partial pressure of arterial oxygen (PaO2) in a healthy adult breathing room air is approximately:
- 40-50 mmHg
- 60-70 mmHg
- 80-100 mmHg (Correct answer)
- 110-120 mmHg
Correct answer: 80-100 mmHg
Normal PaO2 is 80-100 mmHg on room air; values below 60 mmHg indicate significant hypoxemia requiring supplemental oxygen.
Question 7: Which of the following signs differentiates epiglottitis from croup in a pediatric patient?
- Presence of stridor
- Barky seal-like cough and gradual onset
- High fever, drooling, and tripod positioning (Correct answer)
- Low-grade fever and rhinorrhea
Correct answer: High fever, drooling, and tripod positioning
Epiglottitis classically presents with high fever, drooling, muffled voice, and tripod positioning (leaning forward to maximize airflow) — not a barking cough.
Paramedics Exam Airway, Respiration, and Ventilation 5
A 6-year-old child in respiratory arrest requires BVM ventilation.
What is the appropriate ventilation rate?