Florida State Paramedic Practice Exam

In what patients is poor bag compliance commonly seen?

1. Chronic obstructive pulmonary disease

2. Sucking chest wounds or tension pneumothorax

3. Asthmatic patients

4. Congestive heart failure patients

The correct answer is: Sucking chest wounds or tension pneumothorax

Poor bag compliance is most commonly seen in patients who have conditions that affect the mechanics of breathing, particularly those involving airway obstruction or structural changes in the thoracic cavity. In the case of sucking chest wounds or tension pneumothorax, these conditions create a situation where air cannot effectively move in and out of the lungs due to the abnormal pressures and the presence of air in the pleural space. A sucking chest wound allows air to enter the pleural cavity during inhalation without allowing it to escape during exhalation, leading to compromised respiratory function. In a tension pneumothorax, there is an accumulation of air that compresses the lung and mediastinal structures, severely affecting lung expansion and compliance. As a result, when attempting to provide assisted ventilation using a bag-mask device, the bag may feel stiff or non-compliant, making it difficult to achieve effective ventilation. In contrast, conditions like chronic obstructive pulmonary disease, asthma, or congestive heart failure can cause different types of respiratory challenges, but they do not typically result in the severe lack of compliance observed with sucking chest wounds or tension pneumothorax. Instead, these other conditions may lead to wheezing, prolonged expiratory phases, or fluid accumulation that can impact breath sounds