lungs

Lung Sounds and Assessment

  • Breath Sounds: When performing a lung assessment, clinicians may encounter situations where breath sounds are not heard.

    • This category does not fall under "normal" or "abnormal" breath sounds. It simply indicates that no sounds were detected during auscultation.

    • If breath sounds are not heard: Document it as "breath sounds not heard."

    • Avoid the use of shorthand like WNL (Within Normal Limits);

      • Such shorthand implies a lack of examination (i.e., "we never listened").

      • If there’s an absence of sounds, it's acceptable to declare you did not hear anything during your assessment.

  • Listening Technique: The posterior lung area is typically easier to assess because the bases generally have louder sounds due to the larger number of alveoli. Nevertheless, results may vary among patients, and even with amplifiers, some sounds may still be difficult to discern.

Pharmacology Overview

  • Pharmacology Definition: The study of drugs, including how they interact with various body systems.

  • Drug vs. Medication:

    • Drug: Any substance that produces a physiological effect on the body.

    • Medication: A specific type of drug used to treat an illness or disease.

    • Not all drugs serve as medications, as medications have therapeutic purposes.

Drug Action

  • The action of a medication refers to its intended therapeutic effect on the body, a term closely associated with its classification.

  • Drug Classification: Drugs are categorized into families based on their action/therapeutic effect. Examples include:

    • Hypertension Medication

    • Diabetes Medication

Types of Effects: Antagonists vs. Agonists

  • Antagonist: Medications that block certain reactions in the body; for example, antihypertensives that prevent blood pressure from rising.

  • Agonist: Medications that cause reactions; e.g., medications that stimulate certain pathways to lower blood pressure.

Sympathetic vs. Parasympathetic Effects

  • Adrenergic (Sympathetic): Related to adrenaline; stimulates the fight or flight response.

    • Adrenergic Agonist: Increases sympathetic response.

  • Cholinergic (Parasympathetic): Corresponds to the rest and digest function.

    • Anticholinergic: Blocks parasympathetic reactions (analogous to easing off the brake).

Receptors and Their Effects

  • Alpha Receptors: Primarily involved in vasoconstriction and dilation.

  • Beta Receptors:

    • Beta-1: Primarily affects the heart. (Think of it as "one heart")

    • Beta-2: Primarily affects the lungs. (Recall "two lungs")

Pharmacokinetics vs. Pharmacodynamics

  • Pharmacokinetics: How the drug moves through the body, including onset, peak, duration, and elimination.

  • Pharmacodynamics: What the drug does to the body (mechanism of action).

Drug Administration Routes

  • Common Forms of Drugs:

    • Pills/Tabs: Solid or liquid formats for oral ingestion.

    • Inhalers: Metered dose inhalers (MDIs) for asthmatics.

    • Injectables: Solutions administered via bullets.

    • Topical: Medication applied to the skin surface (e.g., creams, patches).

    • Gases: Various inhaled medications.

Routes of Administration from Slowest to Fastest

  1. Oral (PO): Slowest route; ingestion.

  2. Intramuscular (IM): Fast; injected into muscle tissue.

  3. Inhalation: Administered via nebulizer or inhalers; faster than IM.

  4. Intranasal: Fast absorption through nasal mucosa.

  5. Sublingual: Quick absorption under the tongue.

  6. Intravenous (IV): Fastest route; direct into the bloodstream.

  7. Intraosseous (IO): Medication delivered into the bone marrow; also very rapid.

Rights of Medication Administration

  • Right Patient: Ensure the medication is given to the correct individual.

  • Right Medication: Confirm the medication corresponds to the intended treatment indication.

  • Right Route: Verify the route of administration aligns with protocols.

  • Right Dose: Check for the correct dosage to avoid potential errors; for example, epinephrine doses should be handled with precision.

  • Right Time: Documentation and follow-up checks post-administration; Reassessment after five minutes for effectiveness.

Asthma and COPD Treatments

  • Asthma: Defined as reactive airway disease characterized by bronchoconstriction and excessive mucus production, leading to airflow obstruction.

    • Signs and Symptoms: Wheezing, shortness of breath, prolonged expiratory phase.

    • First-line medication: Albuterol, typically delivered via nebulizer or MDI.

    • Additional Medication: Ipratropium bromide (DuoNeb) to assist with mucus.

  • Chronic Obstructive Pulmonary Disease (COPD): Includes emphysema and chronic bronchitis, leading to obstructed airflow.

    • Management: Similar to asthma; bronchodilators (e.g., albuterol) and possibly corticosteroids but refined in scope for EMT training.

Administration Considerations

  • CPAP: Continuous Positive Airway Pressure utilized for patients experiencing restrictions.

    • This device maintains alveoli expansion during breathing, improving gas exchange efficiency.

Conclusion

  • Ensuring accurate administration and following protocols is critical for patient safety and effective treatment. Continuous monitoring and readiness to adapt in emergency scenarios are essential aspects of respiratory management training.