1. What is the best Endotracheal intubation is frequently needed for support-
airway device to ive therapy in the management of inhalation injury.
use for smoke in-
halation?
2. Most pertinent Ventilation is the movement of air in and out of the lungs
piece of informa- through a patent airway. The majority of observations re-
tion in evaluating garding ventilation focus on the movements of the chest.
a patient's venti-
latory status? SIGNS OF ADEQUATE VENTILATION:
In most patients, your assessment of ventilation will be
based on observing their respiratory rate (normal 12 to
20) and listening for clear breathing sounds in the left and
right chest. Auditory confirmation of breathing sounds is
the strongest sign of adequate ventilation. In patients on
ventilators or bag-valve-mask, this does not change.
3. Most pertinent Oxygenation is the delivery of oxygen to the tissues of
piece of informa- the body, poor ventilation or respiration will generally lead
tion in evaluating to poor oxygenation. Loss of oxygenation is the ultimate
a patient's oxy- result of ventilatory or respiratory failure. You need to ob-
genation status? serve the patient's mental status, skin color, oral mucosa,
and check a pulse oximeter.
Mental status is either normal or abnormal, assessing
mental status is based on asking questions about who the
person is, what time/date it is, where they are, and why
they are here.
Skin and mucosal color are important indicators of oxy-
genation. Just as with poor respiration, cyanosis, pallor,
or mottling are signs of decreased oxygen delivery.
Pulse oximetry level is the most objective measure of oxy-
genation, it reads the saturation of hemoglobin (reported
as SPO2), note that a pulse oximeter is not foolproof.
A patient with poor oxygenation in the limbs may have
sufficient oxygenation to their core or vise-versa. Pulse
oximeters can also be fooled by specific toxic gases.
, PLATINUM FINAL EXAM EMTP 3.3 REVIEW
Always ensure that you match up your pulse oximetry
readings with physical findings and ensure they support
one another. Pulse oximeters are imperfect and are not a
real-time measure of O2 saturation
4. Most important Prior to applying supplemental oxygen, objective data
assessment in regarding patient status should quickly be obtained such
evaluating a pa- as airway patency, respiratory rate, pulse oximetry, and
tient's oxygen lung sounds. Signs of cyanosis in the skin or nail bed
delivery to the assessment should also be noted.
brain?
5. What is the next BVM
step to take if a
patient's breath-
ing does not im-
prove with an
NRB?
6. What is the next After manually opening an unconscious patient's airway,
step to take af- you should: check the mouth for secretions, foreign bod-
ter opening the ies, or dentures. If clear, then started manually ventilating!
airway of an un-
responsive pa-
tient with slow,
shallow respira-
tions?
9. When to use One intubation attempt with the definitive airway on pa-
what airway de- tients in cardiac arrest before a provider can attempt
vice given a sce- placement of a supraglottic airway (King Airway). If the
nario / When to first attempt fails, the provider may attempt at intubation
use what ventila- again, or elect to place the King Airway or return to the
tion device giv- BLS airway (BVM).
en a scenario: ET
Tube
10. When to use These devices are best used when the ET Tube does not
what airway de- work.
vice given a sce-
nario / When to
use what ventila-
tion device given
a scenario: King
LT
11. When to use It is secured in the throat via the inflation cuff, although the
what airway de- seal of the LMA is not as effective as that of an ETT. An
vice given a sce- iGel works the same way, and does not have an inflatable
nario / When to cuff.
use what ventila- These devices are best used when the ET Tube does not
tion device given work.
a scenario: LMA /
iGel
12. When to use Used for patients with CHF, or drowning victims. Used to
what airway de- help get fluid out of the lungs that is signified by crackles
vice given a sce- or rales. Must meet requirements of blood pressure and
nario / When to consciousness to be used. Can have a nebulizer connect-
use what ventila- ed if the situation requires it.
tion device given
a scenario: CPAP
13. When to use Used for minimal oxygen for patients that have a lower
what airway de- SPO2 than 95%
vice given a sce-
nario / When to
use what ventila-
, PLATINUM FINAL EXAM EMTP 3.3 REVIEW
tion device given
a scenario: Nasal
Cannula
14. When to use Used for patients that require more than 6L of oxygen,
what airway de- and can be used with a nebulizer for maximum efficiency.
vice given a sce-
nario / When to
use what ventila-
tion device giv-
en a scenario:
Non-Rebreather
15. When to use BLS airway that is used initially before an advanced air-
what airway de- way, and connected to one if one is placed.
vice given a sce-
nario / When to
use what ventila-
tion device given
a scenario: BVM
16. TX of a patient If 0.3mg IM 1:1000 Epi does not work, peripheral perfu-
in anaphylaxis sion isn't good enough to circulate the medication! IV EPI:
when epineph- 1:10,000 is the only solution to get the epinephrine to the
rine has failed to patient.
improve the pa-
tient's condition
and he/she is de-
teriorating
17. Know the advan- Once established, surgical cricothyroidotomy has a num-
tages and dis- ber of advantages over use of a cannula - provision of a
advantages of a definitive airway (protection by a cuffed tube) being just
surgical vs nee- one. Despite this, the technique is used far less frequently.
dle cricothyroto- This may be due to fears about the complication of hem-
my. Which one is orrhage.
the quickest to
perform? Research suggests that needle cricothyroidotomy can
provide effective ventilation in the presence of increasing
airway obstruction. The failure of the needle systems in
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