Emergency Medical Technician (EMT) Basic Certification Practice Exam

What intervention is contraindicated in a patient with a pneumothorax?

1. Oxygen therapy

2. CPAP

3. Intubation

4. Bag-mask ventilation

The correct answer is: CPAP

In the context of a pneumothorax, continuous positive airway pressure (CPAP) is contraindicated because it can increase intrathoracic pressure. This elevated pressure may further compromise lung expansion, which is already impaired due to air in the pleural space. When CPAP is applied, it forces air into the lungs under positive pressure, potentially worsening the situation by pushing air into the pleural space if a rupture already exists. Oxygen therapy is typically safe and beneficial for a patient with a pneumothorax, as it can help improve oxygenation without significantly affecting intrathoracic pressures. Intubation may also be necessary depending on the patient's level of consciousness and the severity of respiratory distress, serving as a means to secure the airway. Bag-mask ventilation can be appropriate in certain scenarios, though care should be taken to perform it gently to avoid introducing additional air into the pleural cavity.