Respiratory Emergencies Study Guide.docx

1. Normal Breathing a. Open airway b. Normal respiratory rate c. Normal respiratory rhythm with adequate tidal volume d. Equal breath sounds 2. Breath Sounds e. Assists in developing a field diagnosis of patient condition f. Listen over bare skin, Never listen...

1. Normal Breathing a. Open airway b. Normal respiratory rate c. Normal respiratory rhythm with adequate tidal volume d. Equal breath sounds 2. Breath Sounds e. Assists in developing a field diagnosis of patient condition f. Listen over bare skin, Never listen over clothes! g. Have patient breathe with their mouth open 3. Wheezing h. Pathophysiology i. High pitched, musical, whistling sound ii. **[Indicates a narrowing of the airways (Bronchoconstriction)]** iii. Mostly heard on exhalation (but not always!) i. Diseases iv. Asthma, Emphysema, Chronic Bronchitis, Pneumonia can all have wheezing 4. Rhonchi j. Pathophysiology v. Snoring, rattling noises vi. Thick mucous secretions vii. Obstruction of larger airways k. Diseases viii. Pneumonia ix. Chronic Bronchitis x. Emphysema (if in the presence of pneumonia) 5. Rales (Crackles) l. Pathophysiology xi. Bubbling, crackling sounds on inspiration xii. Fluid build up in alveoli m. Diseases xiii. Pulmonary edema xiv. Congestive heart failure 6. General signs and symptoms of respiratory distress n. Complaint of shortness of breath o. Sign of hypoxia (mild or severe signs) p. Wheezing, rhonchi, or crackles (rales) q. Tripod positioning r. Accessory muscle use (AMU) 7. Stages of Respiratory Distress (This is important!) s. Respiratory rate and tidal volume xv. Adequate rate is 8-24 breaths per minute t. **[Respiratory Distress]** xvi. **[Subjective complaint of difficulty breathing]** xvii. **[Respiratory rate and tidal volume are adequate]** xviii. **[Treatment would be non-rebreather]** u. **[Respiratory Failure]** xix. **[Respiratory rate or tidal volume, or both, are inadequate]** 1. **[Rate less than 8 or greater than 24]** 2. **[Shallow and ineffective respirations]** xx. **[Treatment would be positive pressure ventilation]** v. Respiratory Arrest xxi. Apnea / not breathing xxii. Treatment would be positive pressure ventilation 8. Metered Dose Inhaler / Small Volume Nebulizers w. EMT's can assist a patient with their metered dose inhaler x. Medications commonly seen xxiii. Albuterol (Ventolin, Proventil) xxiv. Combivent (albuterol and Atrovent) y. Indications xxv. Signs and symptoms of respiratory distress xxvi. Patient has a metered dose inhaler prescribed to them xxvii. EMT has received on-line or off-line medical direction to assist with administration z. Contraindications (opposite of indications, means do not use under these situations) xxviii. The patient has an altered level of consciousness xxix. The inhaler is not prescribed to the patient xxx. Medical directions has not granted approval xxxi. Patient has taken the maximum allowable dose a. Actions xxxii. Beta 2 agonist xxxiii. Relaxes bronchiole smooth muscle to dilate lower airways b. Side Effects xxxiv. Tachycardia xxxv. Tremors, shakiness xxxvi. Nervousness xxxvii. Dry mouth xxxviii. Nausea/Vomiting