Question is driving me crazy???

[akflightmedic]

If you have a patient with audible wheezing and then the wheezes stop prior to medication administration, one of two things most likely have happened.

1. Your patient has stopped breathing and needs a BVM.

2. Your patient is not barely moving any air at all, hence the wheezing stopping..so this pt will need aggressive airway interventions.

So to answer the question, continue with the neb treatment and in real life be prepared to BVM.

 

[medic417]

If you have a patient with audible wheezing and then the wheezes stop prior to medication administration, one of two things most likely have happened.

1. Your patient has stopped breathing and needs a BVM.

2. Your patient is not barely moving any air at all, hence the wheezing stopping..so this pt will need aggressive airway interventions.

So to answer the question, continue with the neb treatment and in real life be prepared to BVM.

That or they were not really wheezing and noise was caused by mouth and throat noise.

 

[Ridryder911]

If it was a registry type question it would be ventilate your patient. I can assure you this

Appearantly, the SVN is not working, you are already monitoring their condition, and the patient has an obstructive airway problems not an upper airway issue at the time. The most appropriate thing is to identify and treat ventilatory problems.

R/r 911

 

[AnthonyM83]

For registry, I would also go with the ventilate question, though I have seen plenty of asthma patients whose lungs were so tight, they were no longer wheezing. Given the albuterol, the wheezing might return as patient bronchioles relax.

The scenario's not very complete, but I wonder if they're trying to get you to recognize extremis. If patient isn't getting air in at all anymore, then he's not going to get that albuterol in, either.

 

[nomofica]

Black Widow, by far.


Coral snake is the second most venemous North American snake, but it uses a much larger supply of venom then compared to a black widow when the bite occurs.

If I'm not mistaken, it can cause necrotizing fasciitis.


However, if the Brown Recluse spider was on that list I'd definitely choose that one. Necrotizing fasciitis is commonplace with a Brown Recluse bite and is more often than not lethal.

 

[Ridryder911]

For registry, I would also go with the ventilate question, though I have seen plenty of asthma patients whose lungs were so tight, they were no longer wheezing. Given the albuterol, the wheezing might return as patient bronchioles relax.

The scenario's not very complete, but I wonder if they're trying to get you to recognize extremis. If patient isn't getting air in at all anymore, then he's not going to get that albuterol in, either.

True but the main emphasis is to recognize the severity of the patient. Continuation of administering the med is not going to be beneficial without the patient ability to ventilate. The key is assessment.

I will say that we had developed several test questions similar or with the main emphasis with the points of assessing your patient and aggressive treatment. For the most part the educators feel that we are tired of seeing the same old answers of perform ABC's and high flow oxygen NRBM @ 15 lpm. I can assure you, some of the members of the NREMT felt the same way. We are tired of memorization and canned treatment responses.

R/r 911

 

[marineman]

Question #2, I'm going to assume that breathing stopped because the airways completely closed. I'd continue assembling the neb, intubate, and send the neb through the tube while administering SQ epi as well. That's my take on it with our lack of information.

Rid has another good point that wheezing that stops could be a partial upper airway obstruction that is either removed or becomes a full upper airway obstruction in which case the neb and epi will do you absolutely no good so I can agree that the best option that covers the most possibilities is the BVM