Prehospital Respiratory Examinations
Prehospital Respiratory Examinations: Techniques for Paramedics and EMTsRespiratory examinations are a vital component of clinical assessment in emergency and prehospital settings. They involve a systematic evaluation of respiratory function and airway status through observation of respiratory effort, rate and rhythm, chest expansion, breath sounds (via auscultation), oxygen saturation, and the presence of abnormal signs such as wheeze, crackles, or stridor. These assessments help paramedics and prehospital clinicians detect respiratory distress, airway obstruction, pulmonary infections, asthma, COPD exacerbations, and other life-threatening respiratory conditions.
In this series, we explore the fundamentals of respiratory examination in the prehospital environment, including essential techniques, red flag indicators, and condition-specific considerations. Whether you’re assessing shortness of breath, suspected chest infection, asthma, or airway compromise, this guide is designed to enhance your assessment skills and equip you to recognise and manage respiratory emergencies with confidence and clinical accuracy.
Prehospital Respiratory Examinations – Articles
Prehospital Respiratory Examinations – Resources
🔗 The Epidemiology and Outcome of Prehospital Respiratory Distress – NLM
An insightful study exploring the incidence, causes, and outcomes of patients experiencing respiratory distress in the prehospital setting. It highlights the clinical significance of early recognition and intervention by EMS providers to improve patient survival and reduce complications.
📥 Coming Soon
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Prehospital Respiratory Examinations – Did You Know?
Shortness of breath is one of the most common respiratory complaints in prehospital care
It can indicate a range of causes, from anxiety and asthma to life-threatening conditions such as pulmonary embolism, pneumonia, acute pulmonary oedema, or tension pneumothorax.
Abnormal breath sounds may indicate airway obstruction or lower respiratory pathology
Wheeze, crackles, stridor, or absent breath sounds can help localise the cause and severity of respiratory distress.
Cyanosis is a late sign of hypoxia
The presence of peripheral or central cyanosis suggests significant oxygen desaturation and requires urgent intervention.
Use of accessory muscles signals increased work of breathing
Visible recruitment of neck, shoulder, or intercostal muscles is a key sign of respiratory distress and impending fatigue.
Capnography provides real-time feedback on ventilation
End-tidal CO₂ monitoring can aid in assessing ventilation, detecting hypoventilation or hyperventilation, and monitoring airway patency, particularly in patients with asthma or COPD.
Prehospital Respiratory Examinations – CPD Reflection Prompts
Reflective practice is a key part of continuing professional development (CPD) and clinical improvement. Use these prompts below to guide your self-reflection on a recent patient assessment.
Reflect on your recent respiratory assessments in the field and consider the following prompts to guide your CPD entry:
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jWhat went well during your respiratory examination?
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jWhat challenges did you encounter?
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jHow did your findings affect your clinical decision-making?
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jHow confident did you feel in interpreting respiratory signs?
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jWhat would you do differently next time?
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Consider writing this reflection in your CPD portfolio or ePortfolio using the Gibbs Reflective Cycle or What? So What? Now What? framework. This reflective exercise not only enhances clinical self-awareness but also provides documented evidence of learning that can count towards your annual HCPC CPD requirements. Keeping detailed, structured reflections like this is essential for maintaining your registration and demonstrating safe, effective, and reflective practice as a healthcare professional. This can count toward your annual HCPC CPD requirements.
Prehospital Respiratory Examinations – FAQs
Frequently Asked Questions about Prehospital Abdominal Examinations in Paramedic Practice
What is included in a prehospital respiratory examination?
A typical prehospital respiratory examination involves assessing respiratory rate, rhythm, depth, and effort; oxygen saturation (SpO₂); chest expansion and symmetry; use of accessory muscles; and breath sounds (via auscultation). Clinicians also check for abnormal signs such as wheeze, crackles, stridor, or absent breath sounds, and observe for cyanosis or fatigue. Capnography, when available, can provide valuable information about ventilation and airway status.
Why is respiratory assessment critical in emergency prehospital care?
Accurate respiratory assessment helps paramedics rapidly identify life-threatening conditions such as airway obstruction, respiratory failure, or hypoxia. Early recognition allows prompt interventions, which can prevent deterioration and improve patient outcomes during transport to definitive care.
What are common signs of respiratory distress paramedics should recognise?
Signs of respiratory distress include increased respiratory rate, use of accessory muscles, nasal flaring, audible wheeze or stridor, cyanosis, altered mental status, fatigue, and inability to speak in full sentences. Recognising these early can guide treatment decisions and the need for advanced airway management.
How do paramedics assess airway patency in the field?
Paramedics assess airway patency by checking for unobstructed airflow, listening for abnormal sounds (snoring, gurgling, stridor), observing chest movement, and noting patient ability to speak. They also perform manual airway opening techniques if needed and may use airway adjuncts to maintain patency..
What is the role of capnography in prehospital respiratory monitoring?
Capnography measures end-tidal CO₂ (EtCO₂), providing real-time information about ventilation effectiveness and airway patency. It is particularly useful for confirming advanced airway placement, monitoring patients with respiratory conditions, and detecting early respiratory fatigue or hypoventilation.
