Respiratory Assessment And History Taking Flashcards
Airway assessment
Determine if the airway is open and clear, if not, consider the need for interventions
Airway intervention considerations
Manual airways adjustment maneuvers, BLS airway adjunct (OPA/NPA), secretion management (recovery position, suctioning), foreign body airway obstruction management, stridor
Breathing assessment
Rate, depth, quality. Consider the need for interventions
Breathing intervention considerations
Nasal cannula (1-4L/min with 100% O2) chest pain or CVA symptoms, NRB (15L/min with 100% O2) signs of obvious respiratory distress with an elevated respiratory rate, BVM (15L/min or >30 breaths/min) signs of obvious ineffective ventilations
Circulation assessment
Radial/carotid rate, rhythm and quality. Consider interventions
Circulation intervention considerations
Pulse less than 50 / greater than 150 (apply AED pads, consider ALS intercept), no pulse (CPR, AED pads)
Head to toe assessment
Whole body, head, neck, chest
Whole body evaluation
Any rash/hives/swelling, any medic alerts
Head evaluation
Pain/discomfort (OPQRST), lightheaded/dizzy/syncopal, visual disturbances, ringing or rushing in the ears, facial droop present, speech deficits
Neck evaluation
Pain or discomfort (OPQRST), any JVD/ trachea midline, any subcutaneous emphysema
Chest evaluation
Any pain or discomfort (OPQRST), any SOB/difficulties breathing, any increased WOB, speech pattern, medication patches/surgical scars, auscultate lungs/heart tones
IPPA
Inspection, palpation, percussion, auscultation
IPPA purpose
To define pathology in order to treat effectively and efficiently
IPPA interpretation
Findings may indicate certain disease processes
IPPA limitations for palpation
has to be done with respect to the patient and in reflection of patients pain level and thoracic expansion is not clinically diagnostic
IPPA limitations for percussion
Cannot be done on elderly or very young patients and diaphragmatic excursion is not clinically diagnostic
IPPA - inspection
Appearance, LOC, WOB, patient condition (history), emergent reason, environment, surroundings, support, vitals
IPPA - inspection; general appearance
Colour (cyanotic, pale), peripheral cyanosis, central cyanosis, pallor, looks ill, scars, bruising, deformities
IPPA - inspection; WOB
Normal, increased (accessory muscle use - retractions, tracheal tug, nasal flaring, pursed lip breathing, stridor, tripod position)
IPPA - inspection; vital signs
BP, HR, RR (rate, rhythm, quality), SpO2, extremities, clubbing, capillary refill, peripheral edema, JVD
IPPA - palpation
Act of touching the patients chest wall to evaluate underlying structure and anatomy
Used to assess pain, fremitus, thoracic expansion, tracheal position, and subcutaneous emphysema
IPPA - palpation; pain
Gently palpating the patients skin can reveal areas of pain
IPPA - palpation; tracheal position
Normal is midline, shifts from the midline are indicative of disease (unilateral pneumonia, pneumothorax, pleural effusion, tumours
What way does the trachea shift for certain diseases?
Towards atelectasis
Away from pneumothorax, pleural effusion, large tumour
IPPA - palpation; vocal fremitus
Vibrations created by the vocal cords during phonation which are transmitted through the parenchyma to the chest wall
IPPA - palpation; tactile fremitus
When these vibrations are felt on the chest wall by a practitioner; having a patient say 99 while repeatedly bilaterally placing hands on patients chest