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Tan- 24yo M BIBA c/o RCP and increased SOB- paramedics suspect a…
Tan- 24yo M BIBA c/o RCP and increased SOB- paramedics suspect a spontaneous pneumothorax
Airways
Are his airways clear?
Is there anything restricting his airways?
restricted airways could indicate a blockage or blood clot in the lungs or circulatory system
Breathing
Respiratory rate, should be 12-20 bpm
Increased respiratory rate indicates he is not getting enough oxygen and may need intervention to help
would expect to have increased respiratory rate due to the SOB and breathlessness
Low respiratory rate indicates he may be having an MI (possibly not due to the area) or pulmonary embolism etc.
Auscultation
You would expect to hear decreased breath sounds on both sides of the lungs, meaning there is not enough air getting to his lungs/rest of his body
wheeze/crackles/stridor if there is a blockage
Assess chest symmetry
would expect to see a loss in chest symmetry on inspiration
Is he using any accessory muscles?
Circulation
Capillary refill
should be < 2 seconds- if it is above this, indicates lack of blood being spread to the periphery
Heart rate
tachycardia indicates pneumothorax- air accumulates between the chest wall and lung (increased pressure in the chest) meaning it reduces the volume of blood to the heart.
bradycardia indicates tension pneumothorax (rapidly developing)
Oxygen saturations
would expect to be lower- not enough oxygen returning to the body
symptoms would explain the SOB and stridor/wheezing in the chest upon auscultation
Blood pressure
Disability
Position
Tripod position indicates pain in the chest area
Level of consciousness
AVPU- is alert/ or only responding to pain or voice
GCS: Score of <8 indicates a declining patient and needs to be escalated immediately
Blood glucose levels
normal is between 3.9-5.6