NREMT Emergency Medical Technician (EMT) Cognitive ExamAirway, Respiration & VentilationMedium
A 55-year-old male with a history of COPD is experiencing acute respiratory distress. He is alert but anxious, with a respiratory rate of 28 breaths/min and shallow breathing. His SpO2 is 88% on room air. What is the most appropriate initial oxygen delivery device for this patient?
- ANasal cannula at 2 L/min.
- BNon-rebreather mask at 15 L/min.
- CVenturi mask at 28% FiO2.
- DBag-valve mask with supplemental oxygen.
Show answer & explanationAnswer & explanation
Correct answer: C. Venturi mask at 28% FiO2.
Patients with COPD often rely on hypoxic drive for breathing. While high-flow oxygen might seem appropriate for an SpO2 of 88%, a Venturi mask allows for precise control of FiO2 (fraction of inspired oxygen), preventing over-oxygenation that could suppress their respiratory drive. A 28% FiO2 setting is a common starting point for controlled oxygen in COPD exacerbations.
Why the other options are wrong
- A. Nasal cannula at 2 L/min provides too low an FiO2 for an SpO2 of 88% and is not precise enough for COPD.
- B. A non-rebreather mask delivers high FiO2, which can be dangerous for COPD patients who may have a hypoxic drive.
- D. A bag-valve mask is used for patients with inadequate breathing or respiratory arrest, not for an alert patient experiencing distress.
Venturi Mask
An oxygen delivery device that provides a precise and consistent fraction of inspired oxygen (FiO2) by mixing a specific volume of oxygen with room air.
- Ideal for patients requiring precise oxygen concentrations, such as those with COPD.
- Different colored adapters correspond to specific flow rates and FiO2 percentages.
- Prevents over-oxygenation in patients with hypoxic drive.
Memory trick: Match the flow to the need, precision saves the COPD seed.