North Carolina EMT State Practice Exam

What should be done if a patient remains cyanotic after mouth to mask ventilation?

1. Increase the flow rate

2. Reposition the patient

3. Switch to BVM

4. Give more breaths

The correct answer is: Reposition the patient

When a patient remains cyanotic after mouth-to-mask ventilation, repositioning the patient is a critical step. Cyanosis indicates that the patient is not receiving adequate oxygenation, which can occur due to improper airway alignment or obstruction. By repositioning the patient, you can help ensure that the airway is properly opened, allowing for better ventilation and oxygenation. Repositioning may involve adjusting the patient's head or neck to achieve an optimal airway position, which is often the result of maintaining the "sniffing" position in case of suspected airway obstruction. It's essential to confirm that the mask is creating a good seal against the patient's face and that no other physical obstruction is preventing air entry into the lungs. While also considering other options, increasing the flow rate or giving more breaths may not improve ventilation if the underlying problem is related to the patient's positioning or airway management. Switching to a bag-valve-mask (BVM) can be appropriate but is typically done after ensuring that the basic ventilation techniques are optimized. Thus, repositioning is a foundational step in managing a patient who continues to show signs of inadequate oxygenation.