NREMT Emergency Medical Technician (EMT) Cognitive ExamAirway, Respiration & VentilationEasy
A patient with a history of emphysema is found to have pursed-lip breathing, a barrel chest, and is using accessory muscles to breathe. These findings are indicative of which of the following?
- AChronic obstructive pulmonary disease (COPD) exacerbation.
- BPneumonia with sepsis.
- CNormal compensatory breathing.
- DAcute asthma exacerbation.
Show answer & explanationAnswer & explanation
Correct answer: A. Chronic obstructive pulmonary disease (COPD) exacerbation.
Pursed-lip breathing, a barrel chest, and accessory muscle use are classic signs of chronic obstructive pulmonary disease (COPD), particularly emphysema, as the patient struggles to exhale trapped air and increase ventilatory effort. These signs become more pronounced during an exacerbation.
Why the other options are wrong
- B. Pneumonia with sepsis would present with fever, cough, crackles, and signs of infection, which are not the primary findings described here.
- C. These are clear signs of respiratory distress and chronic lung disease, not normal breathing.
- D. Asthma exacerbation typically involves wheezing and air trapping, but a barrel chest is a chronic finding, and pursed-lip breathing is more characteristic of emphysema.
COPD (Emphysema)
A chronic lung disease characterized by the destruction of the alveoli, leading to air trapping, reduced gas exchange, and increased work of breathing.
- Common signs include barrel chest, pursed-lip breathing, accessory muscle use.
- Patients often have a chronic cough and dyspnea.
- Smoking is the leading cause.
Memory trick: A chronic wheeze or a barrel chest, tells a tale of lung's long test.