Immediate assessment priorities for any difficulty breathing call include quickly determining if the patient has a febrile illness, most efficiently done by asking the patient if they feel feverish. These include difficulty speaking between breaths and the presence of cyanosis and diaphoresis, each of which are objective and significant assessment findings.(3) Although any dispatch for difficulty breathing could be serious, the presence of these objective findings certainly raises the index of suspicion. Besides ineffective breathing or respiratory arrest, which are suggested though information volunteered by 9-1-1 callers, some objective assessment clues can often be obtained by 9-1-1 operators. Attempts to stratify the significance of respiratory distress by emergency medical dispatch (EMD) protocols have been largely unsuccessful, leaving most EMD protocols to triage patients with breathing problems into a high-priority response. Thus, a rapid and thorough assessment is crucial.Ĭomplaints of dyspnea account for a significant number of EMS responses. Studies have repeatedly demonstrated that EMS providers under-treat pain, largely because of under-assessment.(2) Patients rarely die of pain, but they often die from acute respiratory distress. Shortness of breath, or dyspnea, is a subjective complaint.(1) As with any subjective complaint, an EMS provider risks undervaluing the significance of the problem if they allow personal bias to interfere with a good search for objective signs of respiratory distress. With everything available to today’s EMS provider, you need some pearls of wisdom for effectively assessing and successfully treating patients having difficulty breathing. Some practices of the past served only to disguise deterioration. Does your patient need medication, suctioning, airway management, ventilation, intubation, non-invasive ventilation or just close observation? The number of treatment choices is increasing, and they’re becoming more complex. Good patient outcomes rely on your ability to assess ventilation, oxygenation, work of breathing (WOB), lung function, airway resistance and air flow. Management of acute respiratory distress isn’t an exact science.
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