NREMT EMT Prep Online

The described findings (audible air movement and bubbling blood from an open chest wound) indicate an open pneumothorax. The immediate priority is to seal the wound with an occlusive (ideally vented) chest seal to reduce air entry into the pleural space and improve ventilation. High-flow oxygen is important and should be provided promptly, but it does not correct the ongoing air leak through the chest wall; seal the open wound first and then continue oxygenation/ventilation support as needed. Chest compressions are only indicated if the patient is pulseless. Positioning for comfort may be helpful after life threats are addressed, but it does not treat the open chest wound. After applying the seal, reassess frequently for worsening respiratory status that could suggest developing tension pneumothorax and arrange rapid transport per protocol.

Increasing work of breathing with decreased breath sounds in a child with asthma can indicate severe bronchospasm, fatigue, and impending respiratory failure. A reduction in wheezing is not necessarily improvement; it may reflect critically limited airflow (“silent chest”). The appropriate next step is the choice describing assisting ventilations with a bag-valve mask (with oxygen as available), frequent reassessment, and requesting advanced medical support/expedited transport per protocol. Offering oral fluids during significant respiratory distress increases aspiration risk. Simply monitoring without intervention delays treatment of a potentially life-threatening deterioration. Stopping care because wheezing is quieter misinterprets a dangerous sign of reduced air movement.

After splinting, the priority is to reassess distal neurovascular status by checking circulation (such as distal pulse, skin color/temperature, and capillary refill), movement, and sensation. This helps confirm the splint has not become too tight and that blood flow and nerve function are intact. Elevation and applying cold can help reduce swelling and pain, and documentation is important, but these actions should occur after confirming distal circulation, motor function, and sensation remain intact.