New York State Basic Emergency Medical Technician (EMT-B) Practice Exam

For a trauma victim with a respiratory rate of 40/min, shallow and irregular, who is pale and has a history of emphysema, the MOST APPROPRIATE treatment would be to:

1. Use a BVM with supplemental oxygen

2. Administer low-concentration oxygen because of emphysema history

3. Administer supplemental oxygen with a high-concentration mask

4. Transport the patient sitting up to ease the patient's dyspnea

The correct answer is: Use a BVM with supplemental oxygen

In this scenario, the trauma victim displays a very high respiratory rate of 40 breaths per minute, which is considered tachypnea. The breathing is shallow and irregular, indicating possible respiratory distress or failure. The patient’s history of emphysema complicates the situation since individuals with this condition may have altered respiratory drive and can be sensitive to high concentrations of oxygen. Using a bag-valve-mask (BVM) with supplemental oxygen is the most appropriate treatment because it allows for controlled ventilation. The BVM can provide positive pressure ventilation, which helps to maintain sufficient tidal volume and improve oxygenation, particularly in a patient who is breathing inadequately or is in respiratory distress. In cases of shallow or irregular breathing, conventional oxygen delivery methods may not adequately meet the patient's needs. While administering low-concentration oxygen might seem reasonable given the emphysema history, it may not provide enough support for this patient’s current respiratory status, especially with the signs of possible hypoxia indicated by pallor. Offering high-concentration oxygen can further risk respiratory depression in emphysema patients who often rely on lower oxygen levels for their drive to breathe. Transporting the patient sitting up can help alleviate some discomfort from dyspnea but does not address the immediate need for adequate ventilation