EMT Review Office Hours: Difficulty Breathing

Three different patients, three different breathing emergencies. For weekly, live review sessions that cover NREMT practice questions for EMT and paramedic, join EMTReview.com.
0:04 - 32 year old male on crack cocaine
2:43 - 70 year old male and BVM decision-making
5:37 - 17 year old male who had a severe asthma attack

[@abbygomez6959]

I passed my registry first try I’ve watched every NREMT Video you’ve made and you helped me sm!!!

[@Limmereducation]

We’re glad to hear that we helped you study hard! Thank you so much for taking the time to let us know! We wish you the best of luck in your EMS career!

[@MGoat76]

For question 9, I think it is overly presumptive. An increase in respiratory rate (over 30) would be cause to bag the pt. A decrease in mental status might be solved with high flow O2 with a non-rebreather mask. Bagging is for ventilatory problems, not necessarily respiratory problems. Not enough info is given. Hopefully NREMT would throw this sort of question out. Thoughts?

[@Limmereducation]

Hey, good question. We are probably in agreement about the two other choices: The history of COPD and the oxygen saturation aren’t in the running. The issue with your reasoning is that the question doesn’t give a number of respirations or amount of increase. You can choose 30 (which still doesn’t mean automatically ventilate the patient) but that is inserting something into the question that isn’t there. The one thing that is part of the formula for respiratory failure-and applicable to the patient in the question-is that altered mental status is part of the decision-making findings and the best of the choices given. A COPD patient in an exacerbation could get up and walk to the door and have their respiratory rate increase from exertion. This is exactly the kind of question the NREMT asks, for a couple of reasons including understanding of respiratory failure and the relevant pathophysiology of hypoxia. The NREMT rarely leaves people feeling like they have enough information. Finally, this question asks which should influence your decision-not be an automatic trigger to ventilate. This type of question is great practice for the new TEI questions because it asks the candidate to pick the most important concept. Thanks for writing!