Respiratory Assessment for EMTs

Introduction

This tutorial provides a comprehensive guide for EMTs on conducting respiratory assessments. Understanding how to effectively assess respiratory patients is crucial in emergency medical services. This guide will cover the assessment techniques, appropriate usage of oxygen delivery devices, and essential principles for enhancing your EMT training.

Step 1: Conducting a Respiratory Assessment

• Initial Observations

  • Assess the patient's overall appearance and level of consciousness.
  • Look for signs of respiratory distress, such as increased work of breathing, use of accessory muscles, or cyanosis.

• Vital Signs Measurement

  • Measure the respiratory rate and rhythm.
  • Check oxygen saturation using a pulse oximeter.

• Auscultation of Lung Sounds

  • Use a stethoscope to listen for normal and abnormal lung sounds.
  • Identify common abnormal sounds like wheezing, crackles, or stridor.

Step 2: Understanding Oxygen Delivery Devices

• Nasal Cannula

  • Use for patients who are mildly hypoxic but can breathe on their own.
  • Deliver 1 to 6 liters of oxygen per minute, achieving 24-44% oxygen concentration.

• Non-Rebreather Mask

  • Indicated for patients with severe hypoxia or respiratory distress.
  • Ensure the reservoir bag is inflated and deliver 10 to 15 liters of oxygen per minute, providing nearly 90% oxygen concentration.

• Bag-Valve Mask (BVM)

  • Use when the patient is unable to breathe adequately.
  • Ensure a proper seal and deliver 15 liters of oxygen per minute.
  • Monitor for adequate chest rise.

• Continuous Positive Airway Pressure (CPAP)

  • Indicated for patients with respiratory failure or severe obstructive sleep apnea.
  • Helps keep airways open and improves oxygenation.
  • Ensure proper fit and monitoring of the patient’s response.

Step 3: When to Use and Avoid Oxygen

• When to Use Oxygen

  • Administer if the patient shows signs of hypoxia or is experiencing respiratory distress.
  • Use supplemental oxygen in cases of trauma, cardiac events, or severe asthma.

• When to Avoid Oxygen

  • Avoid using high-flow oxygen in patients with chronic obstructive pulmonary disease (COPD) unless they are in severe distress.
  • Monitor for signs of carbon dioxide retention and assess the need for additional interventions.

Step 4: Practical Tips for Effective Assessment

• Communication

  • Use clear language with the patient to understand their symptoms.
  • Ask about history of respiratory illnesses or recent infections.

• Documentation

  • Record findings promptly, including vital signs, lung sounds, and interventions applied.
  • Maintain an accurate account for further medical care and transport.

• Common Pitfalls to Avoid

  • Neglecting to assess the patient's history.
  • Failing to monitor oxygen saturation continuously during treatment.

Conclusion

Effectively assessing respiratory patients is essential for EMTs to provide timely and appropriate care. By mastering the use of oxygen delivery devices and understanding when to use them, you will enhance your ability to manage respiratory emergencies. Continue to practice your assessment skills, keep learning, and stay informed about the latest protocols in EMS care.