lecture outline Chapter 16 – Respiratory Emergencies (Emergency Care & Transportation, 12e)

lecture outline A comprehensive set of 50 Q&A flashcards covering anatomy, physiology, pathophysiology, assessment, and management topics related to Chapter 16 – Respiratory Emergencies.

What structures make up the upper airway?

Nose and mouth, jaw, oral cavity, pharynx, and larynx.

Which organs comprise the lower airway once air passes the vocal cords?

Trachea, bronchi, bronchioles, and alveoli.

What is the primary function of the lungs?

Respiration – the exchange of oxygen and carbon dioxide.

During which respiratory process is oxygen taken into the blood?

Inspiration (inhalation).

During which respiratory process is carbon dioxide expelled from the body?

Expiration (exhalation).

How does the brainstem regulate breathing?

By sensing arterial CO₂ levels; high CO₂ → faster/deeper breaths, low CO₂ → slower/shallower breaths.

Define hypoxic drive.

A backup breathing control that relies on low oxygen levels when chronically high CO₂ has desensitized the primary drive.

List three broad categories that can hinder gas exchange in the lungs.

Abnormal airway anatomy, disease processes, and traumatic conditions affecting ventilation or perfusion.

Give two classic signs of inadequate breathing.

Altered mental status and abnormal/absent breath sounds (others include cyanosis, accessory-muscle use, etc.).

Name four conditions that commonly cause dyspnea.

Pulmonary edema, asthma/COPD, pneumonia, and pulmonary embolism (others include pleural effusion, airway obstruction, etc.).

What are the hallmark signs of croup?

Stridor and a seal-like barking cough in children 6 months–3 years old.

How should an epiglottitis patient be managed in the field?

Position of comfort, high-flow oxygen, avoid agitation, and do NOT insert anything in the mouth.

Which virus is a frequent cause of bronchiolitis in infants?

Respiratory syncytial virus (RSV).

Bacterial vs. viral pneumonia – which typically presents faster with higher fever?

Bacterial pneumonia.

What infectious disease produces a ‘whoop’ sound after a coughing spell?

Pertussis (whooping cough).

List two key COVID-19 symptoms beyond typical flu-like complaints.

Inspirational chest pain and anosmia (loss of smell).

Which patient populations have a higher prevalence of active tuberculosis?

Homeless, prison inmates, nursing home residents, IV drug or alcohol abusers, and people with HIV.

Define acute pulmonary edema.

Fluid accumulation in alveoli/lung tissue (often from left-sided heart failure) causing dyspnea and frothy pink sputum.

What umbrella term covers emphysema and chronic bronchitis?

Chronic obstructive pulmonary disease (COPD).

Which breath sounds are classically associated with ‘wet lungs’ of pulmonary edema?

Crackles (rales) or rhonchi.

Describe the pathophysiology of asthma.

Acute bronchiolar spasm, mucosal edema, and excessive mucus production leading to wheezing and expiratory difficulty.

What is the definitive prehospital drug for anaphylaxis?

Epinephrine (via auto-injector or per protocol).

Define spontaneous pneumothorax.

Non-traumatic accumulation of air in the pleural space causing partial/total lung collapse.

How do patients with pleural effusion often prefer to sit?

Upright (to ease lung compression discomfort).

Which assessment acronym is tailored for shortness of breath?

PASTE (Progression, Associated chest pain, Sputum, Talking tiredness, Exercise tolerance).

List two adventitious breath sounds and their typical associations.

Wheezes – asthma/COPD; Crackles – pulmonary edema or pneumonia (others: rhonchi, stridor, diminished).

What oxygen device delivers near-100 % oxygen for most conscious respiratory patients?

Nonrebreathing mask at 15 L/min.

When is CPAP indicated pre-hospital?

Moderate-to-severe respiratory distress with adequate mentation, e.g., acute pulmonary edema or COPD exacerbation, per protocol.

Why should EMTs avoid paper-bag rebreathing in hyperventilation syndrome?

Risk of worsening hypoxia if the hyperventilation is actually due to serious medical illness.

What poisonous gas is odorless, tasteless, and produced by fuel-burning appliances?

Carbon monoxide (CO).

How is carbon monoxide poisoning primarily treated in the field?

High-flow oxygen via nonrebreather mask; consider hyperbaric facility if available.

List the five parts of the OPQRST pain/respiratory assessment.

Onset, Provocation/Palliation, Quality, Radiation, Severity, Time.

What are the common side effects of beta-agonist inhalers?

Increased pulse, nervousness, and muscle tremors.

Describe the proper patient positioning for severe respiratory distress.

High Fowler (sitting upright) unless contraindicated; allows maximal lung expansion.

Name two contraindications to EMT-assisted MDI use.

Patient unable to coordinate inhalation or the inhaler is not prescribed/indicated for current complaint (other: max dose already taken, etc.).

What physical sign is often seen in long-term COPD patients’ fingers?

Digital clubbing (bulbous finger tips).

Which respiratory disorder is genetic, leads to thick mucus, and frequent lung infections in children?

Cystic fibrosis.

When assisting a patient with a nebulizer, what flow-rate of oxygen is generally required?

6–8 L/min to create adequate mist (per local protocol).

Define pulmonary embolism.

A blood clot (or other embolus) lodged in a pulmonary artery blocking blood flow through part of the lung.

List three classic signs of pulmonary embolism.

Sudden dyspnea, sharp chest pain, and tachycardia (others: tachypnea, hypoxia, hemoptysis, cyanosis).

What life-threatening complication can spontaneous pneumothorax evolve into?

Tension pneumothorax.

State two key elements of scene safety for suspected airborne infection.

Use appropriate PPE (gloves, eye protection, N95) and limit exposure time; consider ventilation/isolation of patient.

Which accessory muscles indicate increased work of breathing?

Neck (sternocleidomastoid), intercostal, and abdominal muscles.

What is the normal respiratory rate range for an adult?

12–20 breaths per minute.

Why must EMTs use caution delivering high-concentration oxygen to chronic CO₂ retainers?

It may depress their hypoxic drive, potentially reducing spontaneous respirations.

Identify two common airway obstructions in unresponsive patients.

Relaxed tongue blocking airway and aspirated vomitus/foreign body.

Explain the difference between rhonchi and wheezes.

Rhonchi: low-pitched rattling from mucus in larger airways; Wheezes: high-pitched musical sounds from narrowed bronchioles.

What does ‘talking tiredness’ in PASTE refer to?

The patient’s inability to speak full sentences due to breathlessness.

In children with asthma, what oxygen delivery method can be used if they won’t tolerate a mask seal?

Blow-by oxygen – holding the mask just in front of the child’s face.

Which skill drills cover MDI and nebulizer assistance in the textbook?

Skill Drill 16-1 for MDI and Skill Drill 16-2 for small-volume nebulizer.

Why is rapid transport emphasized for dyspneic patients?

Respiratory status can deteriorate quickly; definitive care and advanced interventions may be needed urgently.