Asthma and Other Respiratory Emergencies

(3 hours: Basic, Intermediate and Paramedic levels)
Purpose: To examine the incidence of asthma and other respiratory emergencies in the emergent patient. Special emphasis will be placed on assessing signs and symptoms, recognizing lung sounds, and using a pulse oximeter to determine base oxygen saturation.

  1. Introduction (5 minutes)

  2. Anatomy and Physiology of the Respiratory System (10 minutes)
    1. Upper Airway
    2. Lower Airway
    3. Pulmonary - Cardiac Interaction

  3. Etiology of Asthma (5 minutes)

  4. Case Presentation (10 minutes)

  5. Pathophysiology of asthma (20 minutes)

  6. Assessment (30 minutes)
    1. Patient history
    2. Physical exam

  7. Management (40 minutes)
    1. ABCs
    2. O2
    3. Bronchodilator therapy
    4. Other pharmaceutical agents
    5. Intubation
    6. Transport

  8. Other Respiratory Conditions (30 minutes)
    1. COPD
    2. CHF
    3. Pneumonia
    4. Turberculosis
    5. Pulmonary Embolism
    6. Anaphylaxis
    7. Hyperventilation Syndrome
    8. Toxic Inhalation

  9. Assessment practicum (20 minutes)
    1. Assessment of lung sounds (ie: rales, rhonchi, wheezes, stridor) using examples from a cassette recording.
    2. Use of pulse oximetry in assessing emergencies with the underlying chronic respiratory involvement.

  10. Test (from April 1996 JEMS) (10 minutes)

References:
Caroline, Nancy, Emergency Care in the Streets, 4th edition, pp. 413-438.
Grant, Harvey, Robert Murray, and J. David Bergeron, Emergency Care, 6th edition, pp. 423-437.
Hafen, Brent and Keith Karen, Prehospital Emergency Care, 3rd edition, pp. 369-380.
"Asthma," by Virginia Mossesso, Jr. and Mike Rice JEMS April 1996, pp. 65-76.

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