August 2013 CE. Site code # E-1213

Transcription

1 August 2013 CE Site code # E-1213 Caring for the Patient with CHF or COPD Objectives by Reviewed/revised by Sharon Hopkins, RN, BSN, EMT-P To view on the Advocate Condell website visit:

2 Date of CE presentation: August 2013 Topic: Caring for the Patient with CHF or COPD Behavioral Objectives: Upon successful completion of this module, the EMS provider will be able to: Identify structures of the upper versus lower airways Discuss physiology of ventilations vs respirations Describe a variety of abnormal breath sounds Define congestive heart failure (CHF) and COPD Describe signs and symptoms of respiratory disease Describe purpose of capnography and interpretation of waveforms List interventions and treatments of respiratory disorders based on Region X SOP s. Describe purpose of CPAP and how it works Describe procedure to set up FlowSafe CPAP system Describe hazards of oxygen toxicity Describe hazards of hyperventilation Discuss indications, contraindications, and procedures of suctioning Actively participate in case scenario discussion Actively participate in review of a variety of lung sounds Successfully complete the post quiz with a score of 80% or better Bibliography Bledsoe, B., Porter, R., Cherry, R. Paramedic Care Principles & Practices, 4th edition. Brady Limmer, D., O Keefe, M. Emergency Care 12th Edition. Brady Region X SOP s; IDPH Approved January 6, /default.asp

3 Abnormal breath sounds Snoring most often caused by upper airway obstruction (i.e.: tongue) Gurgling indication of fluid in airway Stridor harsh, high pitched sound heard on inspiration; usually indicates upper airway obstruction Gasping indicates ineffective ventilations Rhonchi rattling sounds in the larger airways Wheezing whistling sound due to narrowing of airways Crackles fine, moist, crackling sound associated with fluid in smaller airways Effects of Coronary Artery Disease (CAD) Waveform Capnography Normal:

4 Flowsafe CPAP Device In-line neb kit with Hudson Brand Neb kit (ie: LFH, GEC) In-line neb kit with Care Fusion brand neb kit (ie: ACMC, AGSH)

5 Is it CHF or Pneumonia??? CHF Pneumonia Dyspnea Orthopnea, PND Dyspnea Recent history Acute wt gain, dependent edema Fever, malaise Cough Frothy sputum Thick mucous Onset Rapid Gradual B/P Usually high Normal Meds Digoxin, antihypertensive, diuretic Antibiotic, cough med Breath sounds Bilateral crackles Exp crackles, insp rhonchi; often unilateral

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7 Pre-Quiz Paramedic and Basic Level From August 2013 CE Material Name Date 1. What does wheezing indicate when auscultated? 2. What do crackles indicate when auscultated? 3. What risk factors or conditions can you list that may predispose a patient to developing heart failure? 4. What are the benefits of using a colorimetric (qualitative measurement) device (i.e.: ETCO2 on the BVM)? 5. What are the benefits of using capnography (quantitative measurement) device during patient care? 6. What information does the pulse oximetry provide?

8 Pre-quiz August 2013 CHF, COPD 7. Per Region X SOP s, what is the treatment for stable and unstable pulmonary edema? Unstable: Stable: 8. What are the risks associated with oxygen toxicity? What are the guidelines in the Region X SOP for using supplemental oxygen? 9. What are the risks associated with prolonged hyperventilation? - What are the proper bagging rates: BVM with infants and children BVM with adults BVM with advanced airway device in place for all persons 10. Suction time should be limited in the adult patient to seconds File: CE, EMS; CE Packets; Quizzes ; 2013 ; August ; The Patient with CHF.COPD