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Reality Training: Patient in respiratory distress

What are the causes of the patient’s distress and what treatments are indicated?

The incident: Patient short of breath

What happened: On a warm spring afternoon you are called for a 57-year-old that is short of breath. You and your partner enter a small, tidy home and find your patient seated on the edge of a chair in a kitchen.

Watch this iSimulate video of the patient’s ECG, SPO2, and ETCO2.

Discussion points: assessment and treatment of respiratory distress

As you watch the video ask yourself or discuss with your partner, company or squad the following questions:

  • Is your patient stable or not stable?
  • What are your immediate treatment actions?
  • What are additional associated signs or pertinent negatives you might expect to see in this patient or learn from the patient’s history?
  • What is a common term for the capnograph you are seeing? Why does it have this appearance?
  • When the patient’s condition worsens how does the treatment plan change?
  • What additional information do you want for this patient?

There are many causes of respiratory distress. The ‘sharkfin’ waveform is associated with asthma and is the result of bronchoconstriction in the lower airways. Interventions for this patient should focus on improving ventilation and oxygenation with the tools and training available to you.

Share your assessments and treatment plan in the comments and review these articles to learn more about capnography, respiratory distress assessment, and asthma.

iSimulate uses the best of current mobile technology to create products that are more advanced, simpler to use and more cost effective than traditional simulation solutions.

Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on LinkedIn.
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