NREMT Emergency Medical Technician (EMT) Cognitive ExamAirway, Respiration & VentilationHard
A 6-month-old infant presents with nasal flaring, grunting, and a respiratory rate of 60 breaths per minute. Their skin is mottled. What is the most appropriate initial treatment?
- AInitiate positive pressure ventilation with a bag-valve mask.
- BAdminister oxygen via nasal cannula at 2 L/min.
- CPlace the infant in the recovery position.
- DPerform a rapid trauma assessment.
Show answer & explanationAnswer & explanation
Correct answer: A. Initiate positive pressure ventilation with a bag-valve mask.
Nasal flaring, grunting, and a respiratory rate of 60 breaths/min, especially with mottled skin, indicate severe respiratory distress and impending respiratory failure in an infant. The infant's compensatory mechanisms are failing, and they require immediate ventilatory support with a bag-valve mask to prevent respiratory arrest.
Why the other options are wrong
- B. Nasal cannula at 2 L/min is insufficient for an infant in severe respiratory distress/failure; the infant needs ventilatory assistance, not just supplemental oxygen.
- C. The recovery position is for unconscious patients with adequate breathing; this infant has inadequate breathing.
- D. A rapid trauma assessment is not indicated for a medical patient presenting with primary respiratory distress.
Pediatric Respiratory Failure
A life-threatening condition where the respiratory system can no longer maintain adequate gas exchange, leading to insufficient oxygenation and/or carbon dioxide elimination.
- Signs include marked tachypnea, severe retractions, grunting, nasal flaring, altered mental status, cyanosis, mottling.
- Often progresses from respiratory distress as compensatory mechanisms fail.
- Requires immediate ventilatory support, often with a BVM.
Memory trick: Grunting, flaring, and mottled skin means 'Bag me now!'