Sarah Kwok
Saturday Hybrid
Signs and Symptoms Notebook
Block 2
Emphysema
● Definition: Emphysema is the most common form of chronic obstructive pulmonary disease (COPD),
and is caused by the overuse of the alveoli. The alveoli resemble balloons, allowing gas exchange in the
lungs. However, once the alveoli wear down and lose their elasticity, the exhalation of air becomes
extremely difficult for the patient. During emphysema, the patient’s alveoli will break down. With large
holes in the alveoli, the residual volume in the lungs increase, because the lungs can’t rid of the excess
air that needs to be exhaled. A patient with emphysema is characterized with “barrel chestedness”,
because of the increased total lung capacity, caused by the excess residual volume. Smoking and age can
increase chances of getting emphysema. Untreated emphysema may lead to hypoxia, CO2 retention,
altered level of consciousness, and loss of consciousness (LOC)
● Risk Factors:
○ Chronic Obstructive Pulmonary Disease (COPD)- Lifestyle Origin
○ Structural
■ Chronic bronchial obstruction
■ Bronchial irritants
■ Lung infections
■ Pneumonia
■ Chronic bronchitis
■ Sputum
■ Excess mucus produced
○ Metabolic
■ Old age
■ Long-term smoking
■ Inhalation of toxic gases or particles
■ Chronic cough
○ Signs & Symptoms
■ “Barrel-chestedness”
■ Shortness of breath
■ Shallow breathing
■ Dry lung sounds
■ Pursed lips, “puffing” while trying to breathe
■ Bronchoconstriction
■ Dyspnea on exertion
■ Cyanosis
■ wheezing/decreased lung sounds
■ Gradually worsening symptoms
■ Tripod position
○ Field Treatment
■ High flow oxygen (10-15 L/min) using nonrebreathing mask with reservoir
■ Strict airway maintenance
■ Epinephrine (based on local protocol)
■ MDI medications (based on local protocol)
■ Bronchodilators that may have been prescribed to the patient (assistance only)
■ Immediate Transport in high Fowler’s position or position of comfort
,Simple (Tension) Pneumothorax
● Definition: Pneumothorax is an acute condition that develops because of a collapsed lung. Air builds up
into the chest cavity, preventing the lung from expanding again. This pressure increases greatly on the
mediastinum. If not treated, pneumothorax can be fatal. The pressure on the lungs will also cause
increased compression on the superior and inferior vena cava, significantly reducing blood flow back to
the heart. If pneumothorax is not treated, dangerous things like hypoxia and obstructive shock can occur.
In addition, the heart may stop beating, resulted from increased pressure.
● Risk Factors:
○ Acute Condition- Developed or sudden
○ Structural
■ Lung tissue damage
■ Chest injury
■ Pulmonary trauma (contusions and hemorrhages)
■ Pneumonia
■ Cystic fibrosis
■ Mechanical ventilation (increased pressure on the lungs)
○ Metabolic
■ Chronic Obstructive Pulmonary Disease (COPD)
■ Great pressures on the lung
■ Pulmonary Embolism
● Signs & Symptoms
○ Cyanosis
○ Sudden chest pain
○ Low blood pressure
○ Increased tidal volume (inadequate rise and fall of the chest)
○ Anxiety
○ Dyspnea (shortness of breath)
○ Decreased lung sounds on one side of the chest
○ Respiratory rates drop
○ Pulse rates drop
○ Tracheal deviation (trachea shifts to opposing side of conflict)
○ Wound sites
○ Subcutaneous emphysema
○ Bulging intercostal muscles and muscles in supraclavicular
○ Sucking sound during inhalation, rushing air during exhalation
● Field Treatment
○ Loosely bandage chest wounds to prevent further infections (if any)
○ Supplemental oxygen via nonrebreathing mask with reservoir
■ Be careful to not increase pressure on the affected side of the lung
○ Immediate transport in high Fowler position or position of comfort
Asthma
, ● Definition: Asthma is a condition where sudden spasms of the bronchioles will cause dyspnea and
difficulty breathing. Asthma patients also have difficulty breathing because of excess mucus production,
and swelling of respiratory passages that are lined with mucus. Asthma is a critical condition that should
be treated right away, or cyanosis and respiratory distress may develop. A prolonged asthma attack
(status asthmaticus) may develop if untreated for too long.
● Risk Factors:
○ Pathologic- Congenital Origin
○ Structural
■ Respiratory infection
■ Partial or complete lower airway obstruction
■ Emotional stress
■ Exercise
○ Metabolic
■ Excessive mucus production
■ Irritated bronchioles
■ Allergic reaction
○ Signs & Symptoms
■ Wheezing on inspiration/expiration
■ Bronchospasm
■ Slightly increased blood pressure
■ Alternate with mucus suction and high flow oxygen
■ Slow and gentle ventilations
■ Normal or elevated pulse rate
● Field Treatment
○ High flow oxygen
○ Immediate transport in high Fowler’s position or position of comfort
○ Assist with prescribed MDI (ex. albuterol or epinephrine) if available
○ Give bronchodilators according to local protocols
○ Consider calling ALS
Pneumonia
● Definition: Pneumonia is an infectious disease that affects gas exchange between the capillaries and
Saturday Hybrid
Signs and Symptoms Notebook
Block 2
Emphysema
● Definition: Emphysema is the most common form of chronic obstructive pulmonary disease (COPD),
and is caused by the overuse of the alveoli. The alveoli resemble balloons, allowing gas exchange in the
lungs. However, once the alveoli wear down and lose their elasticity, the exhalation of air becomes
extremely difficult for the patient. During emphysema, the patient’s alveoli will break down. With large
holes in the alveoli, the residual volume in the lungs increase, because the lungs can’t rid of the excess
air that needs to be exhaled. A patient with emphysema is characterized with “barrel chestedness”,
because of the increased total lung capacity, caused by the excess residual volume. Smoking and age can
increase chances of getting emphysema. Untreated emphysema may lead to hypoxia, CO2 retention,
altered level of consciousness, and loss of consciousness (LOC)
● Risk Factors:
○ Chronic Obstructive Pulmonary Disease (COPD)- Lifestyle Origin
○ Structural
■ Chronic bronchial obstruction
■ Bronchial irritants
■ Lung infections
■ Pneumonia
■ Chronic bronchitis
■ Sputum
■ Excess mucus produced
○ Metabolic
■ Old age
■ Long-term smoking
■ Inhalation of toxic gases or particles
■ Chronic cough
○ Signs & Symptoms
■ “Barrel-chestedness”
■ Shortness of breath
■ Shallow breathing
■ Dry lung sounds
■ Pursed lips, “puffing” while trying to breathe
■ Bronchoconstriction
■ Dyspnea on exertion
■ Cyanosis
■ wheezing/decreased lung sounds
■ Gradually worsening symptoms
■ Tripod position
○ Field Treatment
■ High flow oxygen (10-15 L/min) using nonrebreathing mask with reservoir
■ Strict airway maintenance
■ Epinephrine (based on local protocol)
■ MDI medications (based on local protocol)
■ Bronchodilators that may have been prescribed to the patient (assistance only)
■ Immediate Transport in high Fowler’s position or position of comfort
,Simple (Tension) Pneumothorax
● Definition: Pneumothorax is an acute condition that develops because of a collapsed lung. Air builds up
into the chest cavity, preventing the lung from expanding again. This pressure increases greatly on the
mediastinum. If not treated, pneumothorax can be fatal. The pressure on the lungs will also cause
increased compression on the superior and inferior vena cava, significantly reducing blood flow back to
the heart. If pneumothorax is not treated, dangerous things like hypoxia and obstructive shock can occur.
In addition, the heart may stop beating, resulted from increased pressure.
● Risk Factors:
○ Acute Condition- Developed or sudden
○ Structural
■ Lung tissue damage
■ Chest injury
■ Pulmonary trauma (contusions and hemorrhages)
■ Pneumonia
■ Cystic fibrosis
■ Mechanical ventilation (increased pressure on the lungs)
○ Metabolic
■ Chronic Obstructive Pulmonary Disease (COPD)
■ Great pressures on the lung
■ Pulmonary Embolism
● Signs & Symptoms
○ Cyanosis
○ Sudden chest pain
○ Low blood pressure
○ Increased tidal volume (inadequate rise and fall of the chest)
○ Anxiety
○ Dyspnea (shortness of breath)
○ Decreased lung sounds on one side of the chest
○ Respiratory rates drop
○ Pulse rates drop
○ Tracheal deviation (trachea shifts to opposing side of conflict)
○ Wound sites
○ Subcutaneous emphysema
○ Bulging intercostal muscles and muscles in supraclavicular
○ Sucking sound during inhalation, rushing air during exhalation
● Field Treatment
○ Loosely bandage chest wounds to prevent further infections (if any)
○ Supplemental oxygen via nonrebreathing mask with reservoir
■ Be careful to not increase pressure on the affected side of the lung
○ Immediate transport in high Fowler position or position of comfort
Asthma
, ● Definition: Asthma is a condition where sudden spasms of the bronchioles will cause dyspnea and
difficulty breathing. Asthma patients also have difficulty breathing because of excess mucus production,
and swelling of respiratory passages that are lined with mucus. Asthma is a critical condition that should
be treated right away, or cyanosis and respiratory distress may develop. A prolonged asthma attack
(status asthmaticus) may develop if untreated for too long.
● Risk Factors:
○ Pathologic- Congenital Origin
○ Structural
■ Respiratory infection
■ Partial or complete lower airway obstruction
■ Emotional stress
■ Exercise
○ Metabolic
■ Excessive mucus production
■ Irritated bronchioles
■ Allergic reaction
○ Signs & Symptoms
■ Wheezing on inspiration/expiration
■ Bronchospasm
■ Slightly increased blood pressure
■ Alternate with mucus suction and high flow oxygen
■ Slow and gentle ventilations
■ Normal or elevated pulse rate
● Field Treatment
○ High flow oxygen
○ Immediate transport in high Fowler’s position or position of comfort
○ Assist with prescribed MDI (ex. albuterol or epinephrine) if available
○ Give bronchodilators according to local protocols
○ Consider calling ALS
Pneumonia
● Definition: Pneumonia is an infectious disease that affects gas exchange between the capillaries and
