EMT Airway Exam with Answers Graded A+
1. Which of the following is the pre- B: Mouth-to-mask technique with sup-
ferred initial method for providing plemental oxygen
artificial ventilations to an apneic Reason:The preferred initial method for
adult? providing artificial ventilations is the
A: Two-person bag-valve-mask mouth-to-mask technique with one-way
technique with 100% oxygen valve and supplemental oxygen at-
B: Mouth-to-mask technique with tached. Evidence has shown that res-
supplemental oxygen cuers who ventilate patients infrequent-
C: One-person bag-valve-mask ly have difficulty maintaining an ade-
technique with 100% oxygen quate seal with a bag-mask device.
D: Flow-restricted, oxygen-pow- Because both of the rescuer's hands
ered ventilation device are freed up when using a pocket face
mask, it is easier to maintain an ad-
equate seal, thus providing more ef-
fective ventilations. Of course, if two
rescuers are available to manage the
airway, the two-person bag-mask de-
vice technique should be used. The
flow-restricted, oxygen-powered ven-
tilation device, also referred to as
the manually-triggered ventilator or de-
mand valve, requires an oxygen source
to function and would thus not be prac-
tical as an initial device for providing
artificial ventilations.
2. The MOST effective way to de- D:assessing the chest for adequate
termine if you are providing ad- rise.
equate volume during artificial Reason:The goal of providing artificial
ventilation is: ventilation is to provide adequate tidal
A:assessing the pulse for an im- volume to the patient so that enough
proving heart rate. oxygen is delivered to the lungs, and ul-
B:checking the skin for improve- timately, the cells of the body. The most
ment of cyanosis. effective way to determine if adequate
C:checking the pupils for in- tidal volume is being delivered is to
creased reactivity. watch for the chest to rise during each
D:assessing the chest for ade- ventilation. Other signs of adequate ar-
quate rise. tificial ventilation include improvement
in skin color, the return of the heart
, EMT Airway Exam with Answers Graded A+
rate to a normal range, and ensuring
that you are ventilating the patient at
the appropriate rate. If the adult is ap-
neic but has a pulse, provide 10 to 12
breaths/min. If the adult is apneic and
pulseless, provide 8 to 10 breaths/min
after an advanced airway device (ie,
ET tube, multilumen airway, supraglottic
airway) has been inserted.
3. Which of the following injuries B: Bleeding within the oral cavity
or conditions should be managed Reason: Any injury or condition that
FIRST? jeopardizes the airway has priority over
A:Fluid drainage from both ears all else. If blood or other secretions with-
B:Bleeding within the oral cavity in the mouth are not suctioned immedi-
C:Bilateral fractures of the fe- ately, aspiration may occur; this signif-
murs icantly increases mortality. After secur-
D:A large open abdominal wound ing a patent airway, control any external
bleeding. Ideally, you and your partner
should treat airway problems and exter-
nal bleeding at the same time.
4. You are assessing a middle-aged B: assist his ventilations with a
male who is experiencing respi- bag-mask device.
ratory distress. The patient has a Reason:Your patient is NOT breathing
history of emphysema and hyper- adequately. He is fatigued; has weak re-
tension. He appears fatigued; has tractions; and labored, shallow breath-
weak retractions; and labored, ing. If you do not treat him immediately,
shallow breathing.Your MOST im- he may stop breathing altogether. You
mediate action should be to: should begin assisting his ventilations
A: administer oxygen with a non- with a bag-mask device and high-flow
rebreathing mask. oxygen. After initiating ventilatory assis-
B: assist his ventilations with a tance, attach the pulse oximeter to as-
bag-mask device. sess his oxygen saturation and auscul-
C: assess his oxygen saturation tate his breath sounds. A nonrebreath-
with a pulse oximeter. ing mask is appropriate for patients with
D: auscultate his breath sounds difficulty breathing who are moving air
to detect wheezing. adequately; this patient is not!
, EMT Airway Exam with Answers Graded A+
5. When ventilating an apneic pa- B: the lungs are difficult to ventilate.
tient, you note decreased ventila- Reason: As it applies to artificial ven-
tory compliance. This means that: tilation, compliance is the ability of the
A: the upper airway is blocked. lungs to expand during ventilation. In-
B: the lungs are difficult to venti- creased ventilatory compliance means
late. that no resistance is met when you
C: fluid is occupying the alveoli. ventilate the patient; you can ventilate
D: you meet no resistance when the lungs with ease. Decreased ven-
ventilating. tilatory compliance means that signifi-
cant resistance is met when you ven-
tilate the patient; the lungs are diffi-
cult to ventilate. Conditions such as
upper airway obstruction, widespread
bronchospasm, fluid in the alveoli (eg,
pulmonary edema), and COPD can
all cause decreased ventilatory compli-
ance.
6. You are dispatched to a residence A: manually open her airway and suc-
for an elderly female who has pos- tion her oropharynx.
sibly suffered a stroke. You find Reason: This patient's airway is in im-
her lying supine in her bed. She is mediate jeopardy! The first step in car-
semiconscious; has vomited; and ing for any semi- or unconscious pa-
has slow, irregular breathing. You tient is to manually open the airway (eg,
should: head tilt-chin lift, jaw-thrust) and ensure
A: manually open her airway and it is clear of obstructions or secretions.
suction her oropharynx. Because the patient has vomited, she
B: Insert a nasal airway and begin likely has vomitus in her mouth, which
assisting her breathing. must be removed with suction before
C: perform a head tilt-chin lift and she aspirates it into her lungs. Mortality
insert an oral airway. increases significantly if aspiration oc-
D: administer high-flow oxygen curs. After opening her airway and re-
and place her on her side. moving any vomitus or secretions from
her oropharynx with suction, you should
insert an airway adjunct (a nasal air-
way in this case; the patient is semicon-
scious and likely has an intact gag re-
flex) and begin assisting her breathing
with a bag-mask device. Her respiratory
, EMT Airway Exam with Answers Graded A+
effort is inadequate and should be treat-
ed with some form of positive-pressure
ventilation, not a nonrebreathing mask.
Placing a semi- or unconscious patient
on his or her side (recovery position) is
only appropriate if he or she is breath-
ing adequately; this patient is not.
7. Which of the following processes B: The intercostal muscles and di-
occurs during inhalation? aphragm both contract.
A: The diaphragm descends and Reason: During the active process of
the intercostal muscles relax. inhalation, the diaphragm contracts,
B: The intercostal muscles and causing it to descend. This increases
diaphragm both contract. the vertical dimensions of the chest. At
C: The diaphragm contracts and the same time, the intercostal muscles
the intercostal muscles relax. (muscles between the ribs) contract, in-
D: The intercostal muscles relax creasing the horizontal dimensions of
and the diaphragm descends. the chest. These two processes cause
intrathoracic pressure to fall, and air
rushes in to fill the lungs. The drawing
of air into the lungs by the actions of
these muscles is called negative-pres-
sure ventilation.
8. A 22-year-old man crashed his D: Carefully tilt his head back and lift up
motorcycle into a tree. He is found on his chin.
approximately 20 feet away from Reason: Regardless of the situation,
his bike and is responsive to pain you MUST be able to establish and
only. He is not wearing a helmet. maintain a patent airway. Without a
You are unable to effectively open patent airway, the patient will die. If you
his airway with the jaw-thrust ma- are unable to effectively open a trau-
neuver. What should you do? ma patient's airway with the jaw-thrust
A: Insert an oral airway and as- maneuver, you should carefully perform
sess his breathing. the head tilt-chin lift maneuver. You can-
B: Apply high-flow oxygen and not assess, not to mention treat, a pa-
assess his carotid pulse. tient's airway if it is not open and clear
C: Suction his oropharynx and of secretions or foreign bodies.
reattempt the jaw-thrust.
