NREMT Paramedic Cognitive ExamAirway, Respiration & VentilationMedium
A 40-year-old male is found unresponsive with shallow, gurgling respirations at a rate of 6 breaths/min. His pulse is weak and rapid. After opening the airway, what is the most appropriate immediate intervention to address his breathing?
- ABegin positive pressure ventilation with a BVM.
- BAdminister oxygen via non-rebreather mask.
- CInsert a nasopharyngeal airway and monitor.
- DPerform chest compressions immediately.
Show answer & explanationAnswer & explanation
Correct answer: A. Begin positive pressure ventilation with a BVM.
Shallow, gurgling respirations at a rate of 6 breaths/min indicate severe respiratory depression and impending respiratory arrest, often called agonal respirations. This patient requires immediate positive pressure ventilation with a Bag-Valve-Mask (BVM) to support breathing and oxygenation.
Why the other options are wrong
- B. A non-rebreather mask provides oxygen but cannot assist with ventilation for a patient with severely depressed breathing.
- C. An NPA is an adjunct to maintain an open airway but does not provide ventilatory support for inadequate breathing.
- D. Chest compressions are indicated for cardiac arrest (absent pulse), not primarily for respiratory depression with a present pulse.
Positive Pressure Ventilation (PPV)
PPV, typically delivered via BVM, manually forces air into the lungs of a patient who is apneic or has inadequate breathing, ensuring oxygenation and ventilation.
- Used for apnea or inadequate breathing.
- Requires a patent airway.
- Delivers breaths manually.
Memory trick: When breathing is 'low and slow', you need to 'blow' with a BVM to make it 'go'.