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A Day In The Life of Mr. Trey

Presented by Briana Pervaiz, EMT-P

First Impressions?

Airway Anatomy

Upper Airway

Lower Airway

Levels of Distress

Causes of Dyspnea and Possible Associated Symptoms

ASTHMA

PROLONGED SEIZURES

1

12

Wheezing/No air movement heard

AMS

ANAPHYLAXIS

2

AIRWAY OBSTRUCTION

13

Flushed skin/hives, generalized edema, laryngeal edema

PULMONARY EMBOLISM

BRONCHITIS

14

3

Chronic productive cough, wheezing, cyanosis

Chest pain, hemoptysis, cyanosis

HYPERVENTILATION

CHF

4

15

Dependent edema, rales, cough, possibly pink and frothy sputum, JVD

ENVIRONMENTAL/INDUSTRIAL EXPOSURE

CROUP

16

5

Fever, barking cough, mostly pediatrics

COLD/FLU

EMPHYSEMA

17

6

Barrel chest, pursed lip breathing, dyspnea upon exertion

TUBERCULOSIS (TB)

18

PNEUMONIA

7

Fever, productive cough, fatigue, bloody sputum, chest pain,

Fever, cough, dark sputum

EPIGLOTTITIS

PNEUMOTHORAX

19

8

Fever, sore throat, stridor, drooling,

Sudden chest pain with dyspnea, decreased lung sounds on affected side, tracheal deviation, JVD

RSV

20

PERTUSSIS (WHOOPING COUGH)

9

Cough, sneezing

Cough, fever, mostly pediatrics

SARS

COPD

21

10

Flu like symptoms which can progress

Shortness of breath mostly from exertion, cough, sputum

MENINGOCOCCAL MENINGITIS

PLEURAL EFFUSION

22

11

Flu like symptoms, fever, headache, photophobia, stiff neck

Decreased breath sounds over affected side

Always treat the patient! Consider SAMPLE, OPQRST, PASTE (Progression, Associated chest pain, Sputum, Talking tiredness, Exercise tolerance), and vitals when evaluating your patient as well to narrow down causes and treatment.

Airway Delivery Devices

First Steps? Treatment?

Ummm... Mr. Trey?

OPA/NPA

Cheostomy

Mr. Trey...

Venturi Mask For Trachs

Suctioning Trachs

BVM with Trachs

Trey Jr.

Nebs/Albuterol

Albuterol dose

  • Adults: 2.5 mg nebulized with 6-8lpm of O2. Repeat once.
  • Peds: Repeat once

2 or older: 2.5mg nebulized

less than 2: 1.25mg nebulized

  • Additional dose requires med consult

Epinephrine 1:1

Epinephrine auto injector dose for:

  • Anaphylaxis/Severe Asthma:
  • less than 5: 0.15mg IM lateral thigh
  • 5 or older: 0.3mg IM lateral thigh
  • Additional doses require med consult

Sources

  • National Heart, Lung, and Blood Institute. National Asthma Edu-cation and Prevention Program Expert Panel Report 2:Guide-lines for the diagnosis and management of asthma. Publication No. 97–4051. Bethesda: National Institute of Health;1997.

  • https://careflightcollective.com/2017/04/30/i-wish-i-knew-then-what-i-know-now-simple-airway-management/

  • 2022 MD Medical Protocol, MIEMSS

  • Emergency: Care and Transportation of the Sick and Injured by Jones and Bartlett, Edited by A. Pollack, L. Barnes, J. Ciotola, and B. Gulli

Questions?

Comments?

Concerns?

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