OPA: corner of the mouth to the earlobe or angle of the jaw, only without a gag reflex.
Before you read
Test yourself first: 5 questions
Question 1 of 5
A 2-year-old with noisy breathing is calm on her mother's lap but screams whenever a mask comes near her face. Her breathing is adequate. The best way to give oxygen is to:
Answer: A. A child with a compromised upper airway who becomes agitated breathes harder and can turn a partial obstruction into a complete one. Blow-by oxygen held near the face while she stays calm with her mother delivers useful oxygen without the distress. Separating her or forcing the mask provokes exactly the crying you are trying to avoid, and withholding oxygen from a child who needs it is never the answer.
Question 2 of 5
A pocket mask has a small nipple on its side. Connecting oxygen tubing to it while you ventilate an apneic patient will:
Answer: A. Exhaled air carries only about 16 percent oxygen, so bleeding oxygen into the mask raises what each breath delivers. The flow is far too gentle to ventilate an apneic patient on its own, so you still give every breath and watch the chest rise; and it has nothing to do with the valve, which is the barrier between you and the patient.
Question 3 of 5
You are ventilating an apneic adult with a bag-valve mask connected to oxygen. You notice the reservoir bag stays flat between squeezes. The most likely cause is that:
Answer: A. The reservoir fills from the oxygen supply between squeezes; if it stays flat, oxygen is not arriving — tubing disconnected, flow off, or an empty tank — and the patient is getting room air. Check the connection and flow. A tight seal and small breaths affect what reaches the lungs, not the reservoir, and spontaneous breathing would still leave it inflating between breaths.
Question 4 of 5
A woman 36 weeks pregnant becomes unresponsive with slow, shallow breathing. Why is prompt assisted ventilation with supplemental oxygen especially important in her?
Answer: A. The enlarged uterus pushes the diaphragm up and shrinks the reserve of air in the lungs, while the mother and fetus together consume more oxygen, so her saturation falls quickly when breathing fails. Lung reserve is reduced, not increased, the fetus takes oxygen from the mother and never gives it, and a bag-valve mask works in pregnancy.
Question 5 of 5
A nasal cannula is the most appropriate oxygen device for which patient?
Answer: A. A nasal cannula delivers low-concentration oxygen at low flows and suits a patient who is breathing adequately with a mild oxygenation problem. Severe distress calls for a high-concentration mask, and a patient breathing 6 times a minute needs ventilation, which no passive device can provide. A pulseless patient with gasps needs CPR, not oxygen alone.
Keep the streak going with more questions like these, each with a full rationale.
What is airway, oxygen & cpap?
Adjuncts and suction keep the airway open, oxygen raises concentration, and only positive pressure moves air for a patient who is not breathing adequately.
Key points to remember
- OPA: corner of the mouth to the earlobe or angle of the jaw, only without a gag reflex.
- NPA: tip of the nose to the earlobe; avoid with signs of basilar skull fracture.
- Suction an adult for no more than 15 seconds, on the way out only.
- Nasal cannula 1–6 L/min; nonrebreather 10–15 L/min with the bag kept full.
- CPAP for an awake, breathing patient in distress who can protect the airway.
Field priorities
- Rate 6 and shallow needs a bag-valve mask — a mask cannot move air.
- Give oxygen below about 94 percent or with distress; titrate to need.
- Remove CPAP if the blood pressure falls.
Coaching the patient
- Oxygenation and ventilation are different problems.
Red flags: act now
- Pneumothorax, vomiting or inability to protect the airway (no CPAP)
- A nonrebreather run at a low flow
Airway, Oxygen & CPAP: FAQs
What are the priority actions for Airway, Oxygen & CPAP in the field?
Rate 6 and shallow needs a bag-valve mask — a mask cannot move air. Give oxygen below about 94 percent or with distress; titrate to need. Remove CPAP if the blood pressure falls.
What findings in Airway, Oxygen & CPAP change your plan or your transport decision?
Pneumothorax, vomiting or inability to protect the airway (no CPAP). A nonrebreather run at a low flow.
What do I need to know about Airway, Oxygen & CPAP for the NREMT?
OPA: corner of the mouth to the earlobe or angle of the jaw, only without a gag reflex. NPA: tip of the nose to the earlobe; avoid with signs of basilar skull fracture. Suction an adult for no more than 15 seconds, on the way out only. Nasal cannula 1–6 L/min; nonrebreather 10–15 L/min with the bag kept full.
What should the crew communicate or document for Airway, Oxygen & CPAP?
Oxygenation and ventilation are different problems.
