National Continued Competency Program - EMT Education Guidelines - Ventilation - Minute ventilation, alveolar ventilation, and assisted ventilation

Sep 23, 2026

Uploaded by Bulrr

National Continued Competency Program: EMT Education Guidelines covers ventilation fundamentals for adult and pediatric patients within EMT scope. The lesson defines minute ventilation and its components, then contrasts adequate versus inadequate breathing using rate and tidal volume. It explains alveolar ventilation, dead air space, and why minute ventilation can look normal while gas exchange remains inadequate. Learners review respiratory distress versus respiratory failure, assessment and timing for ventilation, adjuncts such as an automatic transport ventilator, pediatric positioning and padding, and the effect of ventilation on venous return, cardiac output, and SpO2, including when positive pressure ventilation is required.

LanguageEnglish

CategoryExam

FormatPDF

Pages74

Reading Time3 h 6 min

AccessFree to download

Ventilation: Core Concepts

Minute ventilation

Adequate vs inadequate breathing

Alveolar ventilation and dead air space

Assisted ventilation and clinical decision-making

Respiratory distress vs respiratory failure

When to ventilate and adjuncts (ATV)

Effects on venous return and cardiac output

Oxygenate vs ventilate

Pediatric ventilation positioning and padding

AHA position on routine newborn suctioning

National Continued Competency Program: EMT Education Guidelines Page intentionally left blank | NCCR Topic | VENTILATION
􀁸 Minute ventilation
􀁸 Effect on cardiac return
􀁸 Assisted ventilation
o Respiratory failure vs. distress
o Assessment – when to ventilate
􀁸 Adjuncts
o Automatic Transport Ventilator (ATV)
􀁸 Positioning | | --- | --- | | Patient Group | Adult and Pediatric | | Provider Level | Emergency Medical Technicians (EMT) | | Instructor Preparation | Review National EMS Education Standards | | Learning Objectives | By the end of this lesson, the student will be able to:
􀁸 Discuss the difference between alveolar ventilation and minute ventilation
􀁸 Differentiate between adequate and inadequate breathing
􀁸 Differentiate between respiratory distress and respiratory failure
􀁸 Recognize and manage a patient that requires assisted ventilations
􀁸 Discuss the effect of ventilation on venous return and cardiac output
o Spontaneously breathing patient
o Artificially ventilated patient
􀁸 Decide when to oxygenate and when to ventilate a patient
􀁸 Recognize the use of automated transport ventilators when managing patients
􀁸 Discuss the use of padding during ventilation of the pediatric patient
􀁸 Understand the AHA’s position on routine suctioning of the newborn | | Curriculum Hours | 3 hours | | CONTENT | Minute ventilation – The volume of air a person moves in and out ofthe respiratory system in one minute
􀁸 Minute ventilation (MV) consists of: Tidal volume x Respiratory rate in one minute
􀁸 Tidal volume (Vt)– The volume of air a person moves in and out ofthe respiratory system in each breath
􀁸 Respiratory rate (Frequency (F))– The number of times a person breathes per minute
􀁸 Minute ventilation = Tidal volume x Respiratory rate
(example: 500mL of air x 12 breaths per minute = 6000mL/minute)
􀃆􀃆 | | | 􀁸 Explain adequate and inadequate breathing based on minute ventilation
o Adequate breathing-In order to have adequate breathing, you must have an adequate minute ventilation (adequate rate AND adequate tidal volume.)
Adequate breathing does not require positive pressure ventilation
􀁸 Inadequate breathing is caused by
o An inadequate tidal volume
o An inadequate rate
o A combination of both
Inadequate breathing requires immediate management with positive pressure ventilation
􀁸 Alveolar ventilation (Va)– The amount of air that moves in and out ofthe alveoli per minute
􀁸 Alveolar ventilation consists of: (tidal volume (Vt) minus dead air (Td) space) multiplied by respiratory rate in one minute.
o Va = (Vt – Vd) x F
􀁸 Tidal volume – The volume of air a person moves in and out ofthe respiratory system in each breath
􀁸 Dead air space – The volume of air during breathing that does not reach the alveoli or is not involved in gas exchange
􀁸 Respiratory rate (Frequency (F))– The number of times a person breathes per minute
􀁸 Alveolar ventilation = (Vt – Td) x F
example:
(500mL of air – 150mL) x 12 breaths per minute = 4200mL/minute)
The difference between minute ventilation and alveolar ventilation is important because alveolar ventilation is the volume of air reaching the alveoli that participates ingas exchange (what oxygenates the blood.)
By increasing the rate of ventilation in a patient with shallow breathing (inadequate tidal volume) may maintain the minute ventilation near normal, however alveolar ventilation (gas exchange) would be inadequate.
􀃆􀃆 | | --- | --- | | | Example: Mrs. Smith has increased her respiratory rate from 12 to 24 times per minute, however her tidal volume with each breath has decreased from 500mL to 250mL. This means that she is breathing faster but shallow. Her minute ventilation is now (250mL x 24 per minute) 6000mL which appears to be normal. Because of her respiratory rate increase she is able to move what appears to be an adequate volume of air per minute. Mrs. Smith’

FAQs

What is the difference between minute ventilation and alveolar ventilation?

Minute ventilation is the total volume of air moved in and out of the respiratory system per minute. Alveolar ventilation is the volume reaching the alveoli for gas exchange, calculated using (tidal volume minus dead air space) times respiratory rate.

How do adequate and inadequate breathing relate to minute ventilation?

Adequate breathing requires adequate minute ventilation from both adequate rate and adequate tidal volume and does not require positive pressure ventilation. Inadequate breathing results from inadequate tidal volume, inadequate rate, or both, and requires immediate management with positive pressure ventilation.

How does ventilation affect venous return and cardiac output?

In a normal patient, negative pressure during inhalation supports venous return needed for adequate cardiac output. During artificial ventilation, positive pressure increases intrathoracic pressure, impeding blood return; more frequent ventilations prolong positive pressure and reduce cardiac output and perfusion.

Sep 23, 2026

Uploaded by Bulrr