EMT Assessment & Management Quiz: Adult Choking Emergency
Clinical Scenario: You are dispatched to a restaurant where a 58-year-old male collapsed at his table. Bystanders report he was eating steak when he suddenly grabbed his throat and fell to the floor. On arrival, he is unresponsive, cyanotic, and not breathing.
Question 1: Pathophysiology
When a large food bolus completely obstructs the larynx in an adult, which physiological change occurs FIRST?
A) Bradycardia from vagal stimulation
B) Cessation of alveolar gas exchange leading to hypoxemia
C) Metabolic acidosis from anaerobic metabolism
D) Cerebral edema from prolonged hypoxia
Question 2: Initial Assessment
You find the patient supine and unresponsive. What is your FIRST action as an EMT?
A) Attempt to visualize the foreign body by opening the mouth
B) Begin chest compressions immediately
C) Perform a jaw-thrust maneuver and attempt rescue breaths
D) Roll the patient to recovery position
Question 3: Airway Management
During CPR on this choking victim, when should you look in the mouth for a visible foreign body?
A) Only if chest compressions fail to generate a pulse
B) Every time you open the airway before attempting ventilations
C) Only after 5 cycles of CPR
D) Immediately perform a blind finger sweep
Question 4: Recognition of Obstruction Severity
Before the patient lost consciousness, which sign would have indicated SEVERE (versus mild) airway obstruction requiring immediate intervention?
A) Loud, forceful coughing
B) Ability to speak in short sentences
C) Silent cough with inability to speak
D) Wheezing audible on auscultation
Question 5: Risk Factor Identification
The patient's wife tells you he had a stroke 6 months ago with some residual left-sided weakness. Which factor MOST increases his risk of fatal choking?
A) Male gender
B) Eating in a restaurant setting
C) Neurological disease affecting swallowing
D) Age over 50 years
Question 6: Anatomical Consideration
Why are adults who choke on large food boluses at higher risk for complete airway obstruction compared to partial obstruction?
A) The adult epiglottis is more rigid and cannot deflect objects
B) Large boluses typically lodge at the laryngeal inlet, completely sealing the airway
C) Adult airways have more mucus production that worsens obstruction
D) The adult trachea is narrower than the esophagus
Question 7: Post-Resuscitation Care
After successfully removing the obstruction and achieving return of spontaneous circulation, the patient remains unconscious. What is the MOST important reason to transport him immediately to the hospital?
A) To evaluate for internal injuries from chest compressions
B) To assess for aspiration pneumonia risk and neurological damage from hypoxia
C) To perform a barium swallow study
D) To place a prophylactic feeding tube
Question 8: Clinical Presentation
Which physical finding would you expect to see in this patient during the initial assessment that indicates severe hypoxia?
A) Flushed, red skin
B) Cyanosis of lips and nail beds
C) Profuse sweating
D) Dilated pupils that are reactive to light
Question 9: Mechanism of Injury
The patient was eating steak when choking occurred. What characteristic of meat makes it the most common cause of fatal choking in adults?
A) High fat content causes laryngeal spasm
B) Meat proteins trigger allergic airway swelling
C) Solid, complex texture that is difficult to chew and forms large boluses
D) Meat is typically consumed with alcohol which paralyzes the airway
Question 10: Differential Diagnosis
A bystander asks if this could be a heart attack instead of choking. Which observation from the scene BEST confirms foreign body airway obstruction rather than cardiac arrest?
A) The patient is cyanotic
B) Witnesses saw him clutch his throat (universal choking sign) before collapsing
C) The patient is unresponsive
D) The patient has no pulse
Instructions: Write out your answers (A, B, C, or D) for each question. When you're ready, I'll provide feedback on your responses with explanations!