Lesson 4 – Management of Specific Respiratory Conditions

Lesson 4 overview

Respiratory emergencies have unique challenges needing tailored assessment and intervention. This lesson covers managing asthma, COPD, pneumonia, pulmonary embolism, pneumothorax, and pediatric airway emergencies. Knowing each condition’s signs and care helps stabilize patients and prioritize rapid transport.

Asthma and COPD lung sounds

Both often cause wheezing. Listen to all lung fields carefully for a thorough assessment.

Asthma treatment

Focus on bronchodilator administration, typically albuterol via nebulizer or metered-dose inhaler per medical control approval. Provide oxygen and position patient tripod or sitting up if preferred.

COPD oxygen caution

Use similar treatments as asthma but target SpO2 88–92% to avoid suppressing hypoxic drive.

COPD additional care

Assist patients with home medications if appropriate. CPAP may help if trained and authorized. Start oxygen while preparing albuterol. Always listen to lung sounds and take vitals before and after treatment.

Pneumonia lung sounds and symptoms

Lung sounds may be wet/fluid-like and localized. Patients may have productive cough—ask about sputum and its color.

Pneumonia positioning and monitoring

Position patient semi-Fowler’s or sitting for comfort; rarely lying flat. Monitor for signs of sepsis: fever, hypotension, tachycardia.

Pneumonia infection control

Use appropriate PPE to protect yourself and prevent spreading infection.

Pulmonary embolism suspicion

Suspect PE with risk factors like recent surgery, immobility, or hormonal therapy. Symptoms include sudden shortness of breath, chest pain, or syncope.

Pulmonary embolism management

Provide high-flow oxygen, position patient semi-Fowler’s, assist ventilations if needed, monitor vitals closely. Rapid transport is critical.

Spontaneous pneumothorax presentation

Sudden chest pain and shortness of breath, often in tall, thin people or those with lung disease.

Spontaneous pneumothorax treatment

Give high-flow oxygen; position with affected side down if tolerated. Patients often anxious, may prefer sitting or pacing.

Tension pneumothorax signs

Look for severe distress, tracheal deviation away from affected side, distended neck veins, and absent lung sounds on affected side. These are late but critical signs.

Tension pneumothorax EMT role

Needle decompression is typically ALS, but be familiar with equipment. Definitive care requires hospital chest tube placement.

Hyperventilation syndrome diagnosis

Rule out serious conditions first. Once confident, treat as anxiety-related.

Hyperventilation syndrome management

Calm and reassure patient. Coach slow, controlled breathing patiently. Avoid paper bag rebreathing unless protocol allows. Provide oxygen if hypoxia develops.

Pediatric epiglottitis signs

Fever and drooling.

Epiglottitis management

Allow child to sit up and lean forward. Avoid throat exam or agitation. Provide high-flow oxygen if tolerated and prepare for rapid transport.

Pediatric croup signs

Fever and barky, seal-like cough.

Croup management

Use cool mist therapy if available. Sit child upright in parent’s lap. Provide oxygen as tolerated. Monitor closely.

Pediatric airway emergencies general

Children can decompensate quickly; keep BVM ready, have low threshold for aggressive care and rapid transport.