Skip to content- First, a much needed review of lung sounds:
- wheezing-lower airway, may indicate asthma
- rails– lower airway, indicates fluid in lungs, may be due to Congestive Heart Failure (CHF)
- rhonchi– lower airway, may be due to pneumonia/bronchitis
- stridor-upper airway, may be due to partial obstruction of airway or anaphylaxis (acute allergic reaction, which may lead to shock)
- for a more in-depth review of lung sounds and auscultation, see this page on EMSWorld.com
- Resp. distress may be due to variety of ailments. You must look for clues to rule out certain causes and to develop a diagnoses
- Some examples:
- look for presence pedal edema (swelling of legs/ankles, “cankles”) to indicate CHF
- ask about asthma or allergies, or past events of similar nature
- Inhaler:
- see reference sheet given in class for full info, these notes are just are just the essentials or extra insights not found on the sheet
- patient must be breathing and alert enough to self-administer. If not, you should ventilate with Bag Valve Mask (BVM)
- Direct patient to fully exhale, puff, breathe in deeply, hold breath as long as comfortably possible, then exhale slowly.
- Follow prescription directions when helping administration
- Nebulizer
- only use if prescribed to patient
- can use pipe or mask form
- if using with O2, should use 6-8L O2 flow
- How to differentiate anaphylaxis and asthma/other less severe reactions:
- Anaphylaxis will present with one, some, or all of the following:
- hypotension
- hives
- stridor
- known allergen
- CPAP
- should use 25L O2 flow. Start CPAP at this setting-do not start at a lower flow and raise it
- be gentle and compassionate with patient to keep them from freaking out/getting claustrophobic. Can encourage patient to put the mask on by themselves if necessary, and then secure it afterwards.
- If CPAP is not available, would be good to use BVM at 25L.
- First, what are opiates?
- Opiates are a class of drugs that can be found and are used in a variety of forms. Can be prescribed or illegal.
- Examples: Vicadin, Oxycodone, Heroine.
- Heroin
- very addictive
- depressant and respiratory system suppressant
- overdose may lead to respiratory arrest and subsequent cardiac arrest
- Signs of opiate overdose:
- Pinpoint pupils
- Resp. arrest
- Evidence of use (needles, drug found near patient, needle marks/injection points on patient etc.)
- ABC’s are important to maintain for overdose
- ventilating for patient may stimulate respiratory drive and get them breathing again