This protocol outlines the assessment and treatment of patients experiencing asthma or bronchospasm. It advises allowing patients to sit in a comfortable position and treating wheezing patients with medications to break bronchospasm. It notes that patients with heart failure and wheezing should not automatically be diagnosed with asthma, and if they have no asthma history their condition is likely cardiac asthma related to heart failure. The protocol instructs EMTs and paramedics to initially assess the patient, manage their airway if needed, provide CPAP if severely distressed, monitor vitals, and transport to the hospital.

1. ASTHMA
Adult Medical Protocol 2.2.2

2. ASTHMA / BRONCHOSPASM
• This protocol is used for patients who are complaining of
dyspnea and who are wheezing.
• Whenever possible, allow these patients to assume
whatever position is comfortable (they may not tolerate
laying flat).

3. • A patient with a history of CHF that has wheezing on
auscultation of lung sounds should not be automatically
classified as an “asthma patient.”
• If the CHF patient does not have a history of asthma or
allergic reaction, the more prudent assessment would be
that of CHF (cardiac asthma) (See CHF/Pulmonary
Edema protocol 2.2.4)

4. Procedure:
BASIC LEVEL: EMT and PARAMEDIC
• Initial Patient Assessment Protocol 2.1.1
• Airway Assessment/Management Protocol 2.1.2
• If severe distress CPAP may or may not help (keep in
mind, it is the medications that will work best to break the
bronchospasm)
• Attach cardiac monitor and pulse oximeter.
• Transport to designated hospital.