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50
EMR
EMT
AEMT
Paramedic
Extended
Respiratory Distress
Respiratory Distress
Universal Patient Assessment
Cardiac Monitor
12-Lead ECG
If
EMT
or STEMI, transmit
Adult IV/IO
Known Asthmatic /
COPD Exacerbation /
Wheezes
Crackles and CHF
Signs with CHF History
Consider
DuoNeb
EMT
Call-In Order
Oxygen
Titrate SpO2 to 94%
Adult Airway Protocol
Consider
CPAP
5 cmH2O
Watch for air trapping
Suspected Pneumonia /
Unknown / Other
Consider
CPAP
10 cmH2O
If hypertensive
Nitro Paste
1”
Or
Nitro Tab
0.4mg SL
Repeat tab every 5 minutes.
Maintain SBP >100
EMTs
may call-in for this order.
Consider
Solu-Medrol
125mg
IV/IO/IM
Support Symptoms
Known asthmatics,
consider
Magnesium Sulfate
2g
IV/IO over 10 minutes
Consider
Adult Epi-Pen
1 dose
EMT
Call-In Order
if treating asthma with
epi-pen
Position of Comfort
Clinical Considerations
If etiology of respiratory
distress is unknown:
Oxygenate
Attempt CPAP
Support symptoms
Avoid overmedication,
as some meds that are
good for COPD are bad
for CHF and vice versa.
Clinical Considerations
AEMTs
and
Paramedics
Consider using 0.3mL
(0.3mg) of Epinephrine
1:1,000 IM in place of epi-
pen if needed.