NREMT Emergency Medical Technician (EMT) Cognitive ExamAirway, Respiration & VentilationHard
A 6-month-old infant is experiencing respiratory distress. You observe nasal flaring, grunting, and a respiratory rate of 60 breaths per minute. Capillary refill is 3 seconds, and peripheral pulses are weak. Which of the following best describes the infant's respiratory status?
- ARespiratory arrest.
- BMild respiratory distress.
- CDecompensated respiratory failure.
- DCompensated respiratory distress.
Show answer & explanationAnswer & explanation
Correct answer: C. Decompensated respiratory failure.
Nasal flaring and grunting are signs of increased work of breathing, indicating respiratory distress. However, a respiratory rate of 60, prolonged capillary refill (normal is <2 seconds), and weak peripheral pulses signify failing compensatory mechanisms and indicate decompensated respiratory failure, progressing towards arrest.
Why the other options are wrong
- A. Respiratory arrest means no breathing. This infant is still breathing, albeit inadequately.
- B. Mild respiratory distress would involve increased work of breathing without signs of poor perfusion or extreme respiratory rates.
- D. Compensated respiratory distress would show signs of increased work of breathing but maintained perfusion (normal capillary refill, strong pulses).
Pediatric Decompensated Respiratory Failure
A critical stage of respiratory compromise in infants and children where compensatory mechanisms are failing, leading to inadequate oxygenation and ventilation, often with signs of poor perfusion.
- Signs include marked increased work of breathing (severe retractions, grunting, gasping), altered mental status, bradycardia, cyanosis, and signs of poor perfusion (weak pulses, prolonged capillary refill).
- This stage can rapidly progress to respiratory arrest.
- Requires immediate aggressive intervention, including positive pressure ventilation.
Memory trick: Distress compensates, but failure decompensates and collapses.