PLATINUM FINAL EXAM EMTP 3.3 LATEST 2023-2024 ACTUAL EXAM 165 QUESTIONS
AND CORRECT DETAILED ANSWERS |ALREADY GRADED A+
1. What is the best airway device to use for smoke inhalation?: Endotracheal
intubation is frequently needed for supportive therapy in the management of inhala-
tion injury.
2. Most pertinent piece of information in evaluating a patient's ventilatory
status?: Ventilation is the movement of air in and out of the lungs through a patent
airway. The majority of observations regarding ventilation focus on the movements
of the chest.
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 piece of information in evaluating a patient's oxygenation
status?: Oxygenation is the delivery of oxygen to the tissues of the body, poor
ventilation or respiration will generally lead to poor oxygenation. Loss of oxygenation
is the ultimate result of ventilatory or respiratory failure. You need to observe 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 oxygenation. Just as with poor
respiration, cyanosis, pallor, or mottling are signs of decreased oxygen delivery.
Pulse oximetry level is the most objective measure of oxygenation, it reads the satu-
ration 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.
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 assessment in evaluating a patient's oxygen delivery to the
brain?: Prior to applying supplemental oxygen, objective data regarding patient
status should quickly be obtained such as airway patency, respiratory rate, pulse
oximetry, and lung sounds. Signs of cyanosis in the skin or nail bed assessment
should also be noted.
,PLATINUM FINAL EXAM EMTP 3.3 LATEST 2023-2024 ACTUAL EXAM 165 QUESTIONS
AND CORRECT DETAILED ANSWERS |ALREADY GRADED A+
5. What is the next step to take if a patient's breathing does not improve with
an NRB?: BVM
6. What is the next step to take after opening the airway of an unresponsive
patient with slow, shallow respirations?: After manually opening an unconscious
patient's airway, you should: check the mouth for secretions, foreign bodies, or
dentures. If clear, then started manually ventilating!
7. Know your ventilation rates: Adult: 12-20/minute
Child: 15-30/minute
Infant: 25-50/minute
8. Flow rates for 02 devices:: Nasal Cannula - 2-6L/min
Nebulizer - 6-8L/min
Non-ReBreather - 10-15L/min
BMV - 15L/min
EndoTracheal Tube - 15L/min
King LTS-D - 15L/min
CPAP - 25L/min (oxygen port)
9. When to use what airway device given a scenario / When to use what venti-
lation device given a scenario: ET Tube: One intubation attempt with the definitive
airway on patients in cardiac arrest before a provider can attempt placement of a
supraglottic airway (King Airway). If the first attempt fails, the provider may attempt
at intubation again, or elect to place the King Airway or return to the BLS airway
(BVM).
10. When to use what airway device given a scenario / When to use what
ventilation device given a scenario: King LT: These devices are best used when
the ET Tube does not work.
11. When to use what airway device given a scenario / When to use what
ventilation device given a scenario: LMA / iGel: It is secured in the throat via the
inflation cuff, although the seal of the LMA is not as effective as that of an ETT. An
iGel works the same way, and does not have an inflatable cuff.
These devices are best used when the ET Tube does not work.
12. When to use what airway device given a scenario / When to use what ven-
tilation device given a scenario: CPAP: Used for patients with CHF, or drowning
victims. Used to help get fluid out of the lungs that is signified by crackles or rales.
Must meet requirements of blood pressure and consciousness to be used. Can have
a nebulizer connected if the situation requires it.
13. When to use what airway device given a scenario / When to use what
ventilation device given a scenario: Nasal Cannula: Used for minimal oxygen
for patients that have a lower SPO2 than 95%
,PLATINUM FINAL EXAM EMTP 3.3 LATEST 2023-2024 ACTUAL EXAM 165 QUESTIONS
AND CORRECT DETAILED ANSWERS |ALREADY GRADED A+
14. When to use what airway device given a scenario / When to use what
ventilation device given a scenario: Non-Rebreather: Used for patients that
require more than 6L of oxygen, and can be used with a nebulizer for maximum
efficiency.
15. When to use what airway device given a scenario / When to use what
ventilation device given a scenario: BVM: BLS airway that is used initially before
an advanced airway, and connected to one if one is placed.
16. TX of a patient in anaphylaxis when epinephrine has failed to improve the
patient's condition and he/she is deteriorating: If 0.3mg IM 1:1000 Epi does not
work, peripheral perfusion isn't good enough to circulate the medication! IV EPI:
1:10,000 is the only solution to get the epinephrine to the patient.
17. Know the advantages and disadvantages of a surgical vs needle cricothy-
rotomy. Which one is the quickest to perform?: Once established, surgical
cricothyroidotomy has a number of advantages over use of a cannula - provision
of a definitive airway (protection by a cuffed tube) being just one. Despite this, the
technique is used far less frequently. This may be due to fears about the complication
of hemorrhage.
Research suggests that needle cricothyroidotomy can provide effective ventilation
in the presence of increasing airway obstruction. The failure of the needle systems
in the presence of upper airway obstruction results from inadequate exhalation via
the narrow 1.5mm lumen of the 13G cannula. Which can lead to:
Barotrauma/pneumothorax = from over-inflation*
Bleeding
Subcutaneous emphysema
Survey data from the prehospital and hospital settings show the needle airway to
be the most frequently used emergency cricothyroidotomy method, whereas the
surgical airway is rarely used.
18. Assessment findings in a patient with a spontaneous pneumothorax: -
Shortness of breath, sudden onset of sharp chest pain, pallor, tachypnea, diaphore-
sis.
Severe symptoms include tachycardia, AMS, cyanosis, decreased breath sounds on
the affected side.
19. Best method to protect a patient's airway who vomits each time you try to
intubate: Inadequate depth of anesthesia or unexpected responses to surgical stim-
ulation may evoke gastrointestinal motor responses, such as gagging or recurrent
swallowing, increasing gastric pressure over and above LOS pressure facilitating
, PLATINUM FINAL EXAM EMTP 3.3 LATEST 2023-2024 ACTUAL EXAM 165 QUESTIONS
AND CORRECT DETAILED ANSWERS |ALREADY GRADED A+
reflux.
In the setting of aspiration, regurgitation occurs three times more commonly than
active vomiting. An unprotected airway, excessively light depths of anesthesia, and
one or more predisposing risk factors for aspiration combine to significantly increase
the risks of aspiration.
A summary of the available strategies for reducing aspiration risk:
Reducing gastric volume (NRB instead of BVM)
Second-generation supra-glottic airway devices
Cricoid pressure
Rapid sequence induction
Position (left lateral, head down or upright)
20. What are the advantages / disadvantages of tracheal intubation vs using an
extraglottic airway device?: Insertion of a supraglottic airway device is simpler and
faster than tracheal intubation, and proficiency requires less training and ongoing
practice.
Tracheal intubation is a more complex skill than supraglottic airway device insertion
and requires 2 practitioners, additional equipment, and good access to the patient's
airway
The strategy of using a supraglottic airway device first also achieved initial ventilation
success more often. Although regurgitation and aspiration occurred with similar
frequency overall, regurgitation and aspiration during or after advanced airway
management were significantly more common in the supraglottic airway device
group. Conversely, patients in the tracheal intubation group were significantly more
likely to regurgitate and aspirate before advanced airway management, possibly
due to less frequent use of advanced techniques to secure the airway in this group
and the increased time required for tracheal intubation compared with insertion of a
supraglottic airway device.
21. What would cause a patient's respirations to be shallow after striking
his/her head while diving: Breathing problems: If the spine is severely com-
pressed, your lungs may not work properly and you can have trouble breathing.
Specifically, the C3, C4, and C5 spinal nerves innervate the diaphragm. After a spinal
cord injury at or above the C5 level, messages from the brain may not be able to get
past the damage, resulting in loss of control over the diaphragm.
This causes breathing to be weakened, therefore it's essential to seek immediate
medical attention. With the help of a ventilator, respiratory functions may be restored.
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