Breathing (Respiratory)

The respiratory system is responsible for one of the most vital functions in the human body—bringing oxygen in and pushing carbon dioxide out. Every breath a patient takes affects their heart, brain, and overall function, which makes assessing respiratory status a top priority in any emergency or hospital setting.

General Respiratory Assessment

  • Check vital signs, including oxygen saturation (SpO₂)
  • Administer supplemental oxygen as needed
  • Auscultate lungs and assess for abnormal breath sounds:
    • Wheezing – may indicate asthma or bronchoconstriction
    • Crackles / Rales – suggests fluid accumulation (e.g., pulmonary edema)
    • Rhonchi – low-pitched rattling, common in mucus buildup or bronchitis
    • Stridor – high-pitched crowing; upper airway obstruction
    • Absent breath sounds – could indicate a collapsed lung (pneumothorax)
    • Labored breathing with cough – may be a sign of pneumonia

Wheezing (Asthma / Bronchoconstriction)

  • Administer a bronchodilator (e.g., Albuterol via inhaler or nebulizer)
  • Monitor SpO₂ and respiratory rate
  • Recommend home nebulizer treatment
  • Discuss asthma action plan or trigger avoidance
  • Discharge with medications and follow-up plan

Fluid in Lungs / Drowning (Pulmonary Edema or Near-Drowning)

  • Elevate the head of bed (Fowler’s position) to ease breathing
  • Administer a diuretic (e.g., Furosemide) to reduce fluid overload
  • Continuously monitor vital signs and oxygen saturation
  • Continue oxygen therapy and other supportive measures as needed

Bronchitis

  • Provide symptom relief:
    • Cough suppressant (e.g., Dextromethorphan)
    • Expectorant (e.g., Guaifenesin)
  • Administer a bronchodilator (e.g., Albuterol)
  • Encourage fluid intake
    • Offer oral fluids or administer IV saline
  • Monitor oxygen saturation and vitals
  • Discharge with home care instructions:
    • Rest, hydration, and prescribed medications

Upper Airway Obstruction

  • Perform a head-tilt chin-lift to open airway
  • Visually inspect the airway for obstruction
  • If blockage is visible, attempt to remove it manually
  • If needed, perform:
    • Back blows
    • Heimlich maneuver
  • Administer oxygen once airway is cleared
  • Monitor vitals
  • Discharge when patient is stable

Collapsed Lung (Pneumothorax)

  • Administer high-flow oxygen
  • Assess vital signs and respiratory effort
  • Prepare and assist with chest tube placement
  • Remove air or fluid from pleural space to re-expand the lung
  • Monitor for improved breath sounds
  • Provide pain management as needed
  • Remove tube once lung function is normalized
  • Discharge when stable

Pneumonia

Symptoms: Cough, Difficulty Breathing, Chest Pain, Fever, Fatigue

  • Order a chest X-ray for diagnosis
  • Administer antibiotics as indicated
  • Provide symptom relief:
    • NSAIDs for fever and discomfort
    • Cough suppressant
    • Expectorant
  • Provide oxygen if SpO₂ is low
  • Encourage fluid intake (oral or IV)
  • Monitor vitals and respiratory status