Cgabryszek: Created page with "Considerations: airway obstruction, foreign body aspiration, chemical exposure, asthma, chronic obstructive pulmonary disease, emphysema, pulmonary edema, upper respiratory infection, bronchitis, pneumonia, pneumothorax, pulmonary embolus, bronchospasm with anaphylaxis. Note: Anxiety and hyperventilation, while possible, are not prehospital diagnoses. Respiratory distress will be treated with oxygen appropriate for the symptoms and delivery device applied. '''Any patient..."

2022-04-03T22:21:21Z

Created page with "Considerations: airway obstruction, foreign body aspiration, chemical exposure, asthma, chronic obstructive pulmonary disease, emphysema, pulmonary edema, upper respiratory infection, bronchitis, pneumonia, pneumothorax, pulmonary embolus, bronchospasm with anaphylaxis. Note: Anxiety and hyperventilation, while possible, are not prehospital diagnoses. Respiratory distress will be treated with oxygen appropriate for the symptoms and delivery device applied. '''Any patient..."

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Considerations: airway obstruction, foreign body aspiration, chemical exposure, asthma, chronic obstructive pulmonary disease, emphysema, pulmonary edema, upper respiratory infection, bronchitis, pneumonia, pneumothorax, pulmonary embolus, bronchospasm with anaphylaxis. Note: Anxiety and hyperventilation, while possible, are not prehospital diagnoses. Respiratory distress will be treated with oxygen appropriate for the symptoms and delivery device applied. '''Any patient requiring ACLS care should have an ALS intercept if logistically possible.'''

{| class="wikitable"
|'''EMR - Emergency Medical Responder'''
|}

# Begin initial medical care
# Administer oxygen
# Assist ventilations if RR < 8 or > 35
# Administer artificial ventilation if respiratory arrest, respiratory fatigue or shallow respirations
# Apply AED and follow AED protocol if PNB
# Insert airway adjunct(s) & verify placement for respiratory arrest
# Assess for hypotension/ shock (HR >130, cap refill > 2 seconds) & follow shock protocol

{| class="wikitable"
|'''EMT – Emergency Medical Technician''' ''Perform/Confirm All Above Interventions''
|}

# Transport with close observation of respiratory status
# If patient has history of CHF, pulmonary edema or heart disease, then assess for:
## Rales
## Peripheral edema
## JVD
## Orthopnea
# Place in position of comfort & re-evaluate CPAP indications
# Initiate CPAP protocol (if trained) as indicated
# Request ALS intercept if
## Ventilations are being assisted
## Respiratory fatigue or shallow respirations
## Pulse oximetry < 90
## CPAP is initiated
# Apply ECG monitor & run strip -
## If trained, if time allows and after all other interventions are completed
# Perform 12-lead ECG (if trained) as indicated '''CONTACT MEDICAL CONTROL'''
# For cases of obvious respiratory distress with clear breath sounds
## Administer high flow oxygen
## Administer '''patient’s prescribed hand-held, metered-dose inhaler''' as appropriate; 1 or 2 puffs if maximum dose not already taken prior to EMS arrival
## Administer '''albuterol (Ventolin)''' 2.5 mg with or without '''ipratropium (Atrovent)''' 500 mcg via nebulizer; May repeat once if no relief
# For diminished breath sounds or wheezing
## Administer '''patient’s prescribed hand-held, metered-dose inhaler''' as appropriate; 1 or 2 puffs if maximum dose not already taken prior to EMS arrival
## Administer '''albuterol (Ventolin)''' 2.5 mg with or without '''ipratropium (Atrovent)''' 500 mcg via nebulizer; May repeat once if no relief
# Provide CPAP with in-line nebulizer for continued respiratory distress after nebulizer treatment

{| class="wikitable"
|'''AEMT – Advanced Emergency Medicine Tech ''' ''Perform/Confirm All Above Interventions''
|}

# Start IV access if chest pain, CHF or respiratory failure
# Administer '''Narcan''' 0.4mg IV/IN for narcotic overdose; May repeat up to max dose of 2 mg; Administer primarily to improve respiratory function '''CONTACT MEDICAL CONTROL'''
# Initiate chest pain protocol for chest pain cases
# For chest pain -OR- pulmonary edema with BP > 100
## Administer '''Nitroglycerin''', 0.4 mg SL. May repeat X 3 doses if BP stays > 100 between doses

{| class="wikitable"
|'''Intermediate & Paramedic '''''perform/ confirm all preceding interventions''
|}

# Treat dysrhythmias primarily

2-12 RESPIRATORY DISTRESS - Revision history