Episode 22 – Airway Obstruction

A patient in the physical therapy gym suddenly begins to cough, which is shortly followed by wheezing. The physical therapist, recognizing the possibility of an airway obstruction, should take which of the following actions?

1. Attempt to ventilate
2. Administer abdominal thrusts
3. Perform a quick finger sweep of the mouth
4. Continue to observe the patient, but do not interfere

Welcome back to the Scorebuilders’ Q and A Podcast! This podcast provides members of the Scorebuilders’ team with the opportunity to explore challenging multiple-choice examination questions with students actively preparing for the licensing examination. My name is Scott Giles and I will be your host for today’s journey.

Ready? Let’s go!

A patient in the physical therapy gym suddenly begins to cough, which is shortly followed by wheezing. The physical therapist, recognizing the possibility of an airway obstruction, should take which of the following actions?

1. Attempt to ventilate
2. Administer abdominal thrusts
3. Perform a quick finger sweep of the mouth
4. Continue to observe the patient, but do not interfere

The primary purpose of the licensing examination is to protect the consumer. As a result, it’s extremely likely that you will encounter questions dealing with emergent conditions.

In this particular question, we’re dealing with the possibility of an airway obstruction. Coughing and wheezing indicate that the airway is not completely obstructed. Based on the presented information, the question is asking the most appropriate therapist action. 

Let’s explore each of the options:

Option 1 - Attempt to ventilate
If the patient is not breathing, a rescuer should open the airway and attempt to ventilate. If the rescuer is unable to make the patient’s chest rise, the rescuer should reposition and ventilate again. If the chest still does not rise, the rescuer must consider that there is an obstruction. This technique would not be appropriate for a person that is coughing or wheezing in an attempt to clear an obstruction.

Option 2 - Administer abdominal thrusts
If the patient is choking, the rescuer should attempt to perform the Heimlich maneuver while the conscious patient is in sitting or standing. The Heimlich maneuver attempts to remove the obstruction by providing abdominal thrusts. The rescuer would press the fist into the patient’s abdomen with a quick inward and upward thrust with the intent of relieving the obstruction. This technique would not be appropriate for a person that is coughing or wheezing.

Option 3 - Perform a quick finger sweep of the mouth
A rescuer should use a finger sweep only when they can see solid material obstructing the airway of an unresponsive patient. If the rescuer were to do this without seeing the blockage, it may harm the patient or rescuer. This technique would not be appropriate for a person that is coughing or wheezing in an attempt to clear an obstruction.

Option 4 - Continue to observe the patient, but do not interfere
If a mild obstruction is present and the patient is coughing or wheezing, the rescuer would not interfere with the patient’s sponta¬neous coughing and breathing efforts. Usually a patient that is coughing will independently dislodge the object causing the obstruction. The rescuer should attempt to relieve the obstruction only if signs of severe obstruction develop such as the cough becoming silent, respiratory difficulty increasing or the patient becomes unresponsive.

The correct answer is Option 4

Let’s explore the all student data:
3% of students selected Option 1
40% of students selected Option 2
10% of students selected Option 3
47% of students selected Option 4, the correct response

System Classification
This question is a Non-Systems question which represents approximately 14% of all exam items.

Content Outline Classification
This question is a Safety and Protection question which represents approximately 3% of all exam items.

Level Classification
This question is a Level 2 question since the question requires students to integrate numerous pieces of information or to apply knowledge in a given clinical scenario. Remediation of Level 2 questions occurs by increasing flexibility with academic content and by carefully analyzing decision making processes when answering applied examination questions.

Thanks for joining us on the Scorebuilders Q and A podcast! See you next week!

Watch the video version of this Q&A episode on YouTube - https://youtu.be/dUWiKmlT6x8