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Chapter Respiratory Emergencies Thirteen
Chapter ,[object Object],[object Object],Thirteen CORE CONCEPTS
R ESPIRATORY SYSTEM
Respiratory System
[object Object],(more easily obstructed). ,[object Object],[object Object],(more easily obstructed). (Continued) Pediatric Airway Anatomy
[object Object],(less rigid) . ,[object Object],[object Object],Pediatric Airway Anatomy
Process of Respiration
[object Object],[object Object],[object Object],Gas Exchange: Alveolar  Capillary
[object Object],[object Object],Gas Exchange: Capillary  Cellular
Adequate Breathing:  Normal Rates (Continued) ,[object Object],[object Object],[object Object],12-20/min. 15-30/min. 25-50/min.
[object Object],[object Object],(Continued) Adequate Breathing: Rhythm
[object Object],[object Object],[object Object],use of accessory  muscles ,[object Object],Adequate Breathing: Quality Adequate tidal volume
[object Object],[object Object],[object Object],(Continued) Inadequate Breathing volume
[object Object],[object Object],inadequate (Continued) Inadequate Breathing
[object Object],(Continued) Inadequate Breathing Increased use of  accessory muscles,  especially in infants and children
[object Object],[object Object],[object Object],Inadequate Breathing
Inadequate Breathing: Infants and Children Retractions Nasal Flaring See-Saw  Breathing Diaphragmatic Breathing
Artificial Ventilation ,[object Object],mask or bag-mask device. ,[object Object],ADEQUATELY.
[object Object],[object Object],10–12/min. for adults 12–20/min. for infants/children ,[object Object],Artificial Ventilation —  Adequate
[object Object],[object Object],[object Object],to normal. Artificial Ventilation  Inadequate
The concept of adequate vs. inadequate breathing is one that must be stressed to  new EMT-Bs.  The mere thought of providing artificial ventilation to a person who has some respiratory effort is confusing. Ventilating a nonbreathing patient is difficult, let alone one who is breathing.  Explain to new EMT-Bs that they should work with the patient’s respiratory effort and coach the patient when appropriate.  P RECEPTOR  P EARL
Breathing Difficulty A chief complaint representing a patient’s feeling of labored or difficult breathing K EY TERM
Patient  ASSESSMENT Breathing Difficulty Signs and Symptoms ,[object Object],[object Object],[object Object],[object Object],decreased (Continued)
Patient  ASSESSMENT Breathing Difficulty Signs and Symptoms ,[object Object],[object Object],[object Object],[object Object],(Continued)
Patient  ASSESSMENT Breathing Difficulty Signs and Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],(Continued)
Patient  ASSESSMENT Breathing Difficulty Signs and Symptoms ,[object Object],[object Object],[object Object],[object Object]
Signs of Breathing Difficulty
Sign of Breathing Difficulty  Tripod Position
Patient  CARE Breathing Difficulty Emergency Care Steps ,[object Object],(Continued) Onset Provocation Quality Radiation Severity Time = = = = = = O P Q R S T
Patient  CARE Breathing Difficulty Emergency Care Steps ,[object Object],[object Object],[object Object],(Continued)
Patient  CARE Breathing Difficulty Emergency Care Steps ,[object Object],patient has used. ,[object Object],[object Object],facilitate use of prescribed inhaler.
Prescribed Inhaler
Medication Name Prescribed Inhaler ,[object Object],isoetharine, etc.) ,[object Object],Ventolin, Alupent, etc.)
Indications Patient must meet all criteria. Prescribed Inhaler ,[object Object],breathing difficulty ,[object Object],[object Object],medical direction
[object Object],[object Object],[object Object],[object Object],Contraindications Prescribed Inhaler
[object Object],Medication Form Dosage ,[object Object],based on physician’s order Prescribed Inhaler
Obtain orders from medical direction.
[object Object],[object Object],to use device. Prescribed Inhaler or warmer. ,[object Object],[object Object]
Right Patient?  Right Medication? Right  Dose?  Right Route? Right Time?  Right Documentation?
Shake vigorously.
[object Object],[object Object],around inhaler opening. Prescribed Inhaler
Depress handheld inhaler as patient inhales deeply. Instruct patient to hold breath.
Allow patient to breathe.  Repeat dose if ordered. Reevaluate patient.
Spacer Device
Actions ,[object Object],[object Object],[object Object],Prescribed Inhaler
Side Effects ,[object Object],[object Object],[object Object],Prescribed Inhaler
Reassessment ,[object Object],[object Object],[object Object],of inadequate breathing Prescribed Inhaler
Prescribed Inhaler: Children ,[object Object],[object Object],[object Object],than wheezing.
1. Describe signs of adequate and inadequate breathing. 2. Explain the indications and  contraindications of a prescribed inhaler. 3. List the “rights” of medication  administration.  R EVIEW QUESTIONS

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