A patient in respiratory distress has diffuse expiratory wheezing, use of accessory muscles, and a history of asthma. Initial paramedic management should prioritize which intervention?
A. Immediate needle decompression of the chest
B. High-dose naloxone administration
C. Nebulized beta-2 agonist (e.g., albuterol) with supplemental oxygen as needed
D. Placing the patient supine and withholding oxygen
Source: Source section/heading: National EMS Education Standards, Paramedic level, Airway/Respiration/Ventilation: pathophysiology and management of asthma/bronchospasm
A paramedic is preparing to perform endotracheal intubation on an apneic adult. Which action confirms correct tube placement immediately after insertion?
A. Auscultating bilateral breath sounds and epigastrium, plus waveform capnography
B. Watching for chest rise only, without auscultation
C. Palpating the cuff at the sternal notch
D. Confirming the patient's oxygen saturation reaches 100% within 10 seconds
Source: Source section/heading: NREMT Paramedic Examination Specifications, Airway/Respiration/Ventilation domain (Assessment/Management); AHA 2020 advanced airway confirmation guidance
Waveform capnography on an intubated patient shows a sudden drop to near-zero ETCO2 with a normal-appearing waveform shape. What does this most likely indicate?
A. Improving perfusion and ventilation
B. Tube dislodgement or complete airway obstruction
C. Normal variation with respiratory rate
D. Hyperventilation causing respiratory alkalosis
Source: Source section/heading: AHA 2020 ACLS guidelines, use of capnography to confirm and monitor advanced airway placement
Which finding on a conscious adult patient with suspected upper airway obstruction from a foreign body indicates the obstruction is complete rather than partial?
A. Loud stridor with a weak but audible cough
B. Mild hoarseness that resolves after a swallow
C. Normal speech with occasional throat clearing
D. Inability to speak, cough, or move air, with hands clutching the throat
Source: Source section/heading: American Heart Association guidance on recognition of choking, complete vs. partial airway obstruction
A paramedic is bag-mask ventilating an apneic adult patient. What ventilation rate is recommended once an advanced airway is in place during a cardiac arrest resuscitation?
A. One breath every 6 seconds (about 10 breaths per minute)
B. One breath every 2 seconds
C. One breath every 15 seconds
D. As fast as possible to maximize oxygen delivery
Source: Source section/heading: AHA 2020 ACLS guidelines, ventilation rate with an advanced airway during continuous chest compressions
