1. Respiratory Emergencies

2. Anatomy of the Respiratory System

4. Inspiration Exhalation

5. Regulation of Ventilation
Body is a constant changing environment
Chemoreceptors monitor bodies CO2 levels and adjust respirations to correct highs and lows.
Hypoxic drive is back-up system if normal system breaks down. (COPD)

6. Chief Complaint SOB Common EMS Response Initial Assessment Appearance
LOC
ABC’s

7. Signs of Adequate Breathing
Normal Rate 12 – 20 breaths/min
Regular pattern, with smooth flow of air
Clear and equal breath sounds bilaterally
Regular and equal chest rise and fall
Adequate depth (tidal Volume)

8. Signs of Inadequate Breathing
Labored breathing
Altered LOC
Respiratory rate less than 12 or greater than 20 with dyspnea
Irregular Rhythm (Cheyne Stokes, Kussmaul, Ataxic pattern)
Inequal chest expansion.
Shallow breathing
Skin Condition
Retractions

9. Factors Effecting Respiration
External factors
Elevation
Oxygen levels
Toxic chemicals
Confined Spaces
Internal Factors
Medical conditions
Non functioning Alveoli
Fluid in lungs
Circulatory problems
Metabolic problems

10. Foreign Body Obstruction
Partial
If able to talk or cough forcefully allow person to attempt to relieve on there own.
If poor air exchange and weak cough provide immediate intervention
Complete
Abdominal thrusts
If pulseless and apneic begin CPR.
Use tongue jaw lift and check back of oropharynx for foreign body
No blind finger sweeps

11. Other Obstructions Dental Appliances Facial injuries
If well fitting and in place leave in
If loose remove to prevent obstruction
Facial injuries
Blood may need to be suctioned
Broken teeth removed

12. Oxygen Delivery Nasal Cannula Non Rebreather Bag Mask with reservoir
1-6 lpm 24%-44%
Non Rebreather
lpm up to 90%
Bag Mask with reservoir
15 lpm %
Mouth to Mask
15 lpm %

13. Ventilation Rates Adults Children and Infants
1 breath every 5 – 6 seconds
Children and Infants
1 breath every 3-5 seconds

14. CPAP Indications Contraindications Awake & Alert Over 12
Patent airway GCS>10
BP above 90 systolic
2 of following
Retrations/Accessory muscle use
Resp rate >24
Pulse Ox <92%
Inability to speak in complete sentences
Contraindications
GCS <11
Respiratory Arrest
BP <90Systolic
Suspected Pneumo
Tracheostomy
Foreign body obstruction
Facial deformity or trauma
Actively vomiting
Recent neuro, facial or gastric surgery
Chest head or face trauma