6. Breathing Problems - CDE

Question 1

Difficulty Speaking Between Breaths

Answer 1

Described as:
* Unable to complete a full sentence w/o taking a breath
* Only able to speak a few words w/o taking a breath
* Breathing attempts that severely hinder crying in infants and small children

Question 2

Changing Colour

Answer 2

• Ashen/Gray
• Blue/Cyanotic/Purple
• Mottled
  (Pale, pink, and red are not colours of clinical significance in dispatch environment and will not, alone, change dispatch priority)

Question 3

Chronic Obstructive Pulmonary Disease (COPD)

Answer 3

Progressive disease that decreases lung function over time. Emphysema (loss of air sac function) and chronic bronchitis (airway inflammation) are the two primary types of COPD. Many patients have both conditions, making COPD a commonly reported term.

Question 4

Problem Suffixes

Answer 4

A: Asthma
E: COPD (Emphysema/Chronic bronchitis)
O: Other lung problems

Question 5

First Law of Chest or Back Pain

Answer 5

“Hurts to breath” is not considered difficulty or abnormal breathing

Question 6

Rule 1

Answer 6

When the complaint description involves both NON-TRAUMATIC chest pain/heart attack symptoms and breathing problems, choose the Chief Complaint Protocol that best fits the patient’s foremost symptom, with ECHO-level conditions taking precedence. (≥ 16, alert, no reported STROKE symptoms) Use Aspirin Diagnostic & Instruction Tool on either protocol as appropriate

Question 7

Rule 2

Answer 7

Breathing problems are potentially life-threatening until proven otherwise

Question 8

Rule 3

Answer 8

A patient having breathing problems may worsen at any time. Always advise to call back if condition worsens.

Question 9

Rule 4

Answer 9

If the caller asks whether the patient should be given their medication now, the EMD should only give instructions included in the protocol.

Question 10

Rule 5

Answer 10

Asthma patients are usually very experienced in managing their disease. When the status of these patients is reported as “can’t breath”, “unable to breath”, or a similar description, this should be considered INEFFECTIVE BREATHING

Question 11

Axiom 1

Answer 11

While true hyperventilation is a benign (not serious) condition, EMDs should never assume it exists. Advising breathing into a paper bag is considered to be EMD malpractice.

Question 12

Axiom 2

Answer 12

Patients with chronic lung disease are often prescribed bronchodilators to be administered at home with an inhaler or nebulizer. Patients who have been prescribed a bronchodilator should be advised to use this medicine, even if they have used it recently.

Question 13

Axiom 3

Answer 13

Inhalers prescribed to prevent asthma attacks (i.e., Advair, Serevent, Symbicort, Spiriva) do not act fast enough to treat sudden asthma attacks

Question 14

Axiom 4

Answer 14

In conscious patients, breathing may be helped by sitting up

Question 15

Problems NOT in the Lungs or Airway

Answer 15

• Cardiac arrest
• Diabetic ketoacidosis
• Drug/Substance abuse
• Heart attack
• Hyperventilation syndrome
• Respiratory arrest (overdose)
• Seizures (epileptic or febrile)
• STROKE (CVA)