We have 2 Americans and we can choose one of them to receive a medal. This can be done in 2 ways.
Choosing a Canadian to receive a medal:
We have 5 Canadians, and we can choose one of them to receive a medal. This can be done in 5 ways.
Choosing a third skater to receive a medal:
After selecting an American and a Canadian, we are left with 17 skaters (19 - 1 American - 1 Canadian). This can be done in 17 ways.
Thus, we have:2 (American's choice).×5(Canadian's choice)×17(third skater's choice)=170 ways