Paramedic National Registry Practice

If there is abnormal movement from the chest wall, what is your first action?

1. Administer pain relief

2. Begin CPR

3. High flow O2

4. Check for rib fractures

The correct answer is: High flow O2

In cases of abnormal movement in the chest wall, providing high flow oxygen is a critical first action. This approach prioritizes the patient’s oxygenation status, particularly if there is potential respiratory compromise due to injury. Abnormal chest wall movement, such as paradoxical motion, can indicate several life-threatening conditions, including flail chest or severe trauma to the thorax that may impair effective breathing and gas exchange. Administering high flow oxygen can help mitigate hypoxia until further assessments and interventions can be made. This is especially vital if the patient exhibits signs of respiratory distress or decreased oxygen saturation. While pain relief may be necessary later to support overall patient comfort and compliance, it does not address the immediate risk of inadequate oxygenation. Beginning CPR could be appropriate if there is no pulse or no breathing, but the presence of abnormal chest wall movement does not automatically indicate the absence of lifesaving breaths. Checking for rib fractures might provide valuable information but is further down the priority list since it does not address the immediate need for oxygen. In summary, focusing on oxygen delivery ensures that the most critical physiological needs of the patient are met promptly, potentially stabilizing their condition as advanced care is initiated.