Module 2.3 Evaluation of the Respiratory System
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Basic Principles of Critical Care
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Module 2.3 Evaluation of the Respiratory System
- 1. EVALUATION OF THE RESPIRATORY SYSTEM Gradian Health Systems Basic Principles of Critical Care RESPIRATORY SYSTEM
- 2. Disclaimer Basic Principles of Critical Care Training I Evaluation of the Respiratory System Disclaimer: Gradian Health Systems cannot provide formal recommendations or indications regarding medical care and clinical service delivery. The tables, checklists, and other clinical documents referenced in this training have not been validated in all settings. These documents are intended to serve as examples only. We recognize that all clinical training content and activities must be customized to meet the needs of each facility and its clinical staff, factoring in available resources, practitioner skill level, and other environmental considerations. For any questions regarding the contents or applications of this training, please contact Gradian Health Systems: 40 W 25th St, 6th Floor New York, NY 10010 USA +1 212-537-0340 training@gradianhealth.org
- 3. Module 2 Gradian Health Systems Basics Principles of Critical Care Respiratory System
- 4. Module 2: Respiratory System MODULE OVERVIEW Lesson 1 I Respiratory System Anatomy and Physiology Lesson 2 I Oxygen Therapy Lesson 3 I Evaluation of the Respiratory System Lesson 4 I Airway Equipment and Management Lesson 5 I Invasive and Non-invasive Ventilation Lesson 6 I Basics of Mechanical Ventilation Lesson 7 I Ventilator Modes and Settings Lesson 8 I Ventilation Complications Basic Principles of Critical Care Training I Evaluation of the Respiratory System
- 5. Components of the Gradian CCV SystemLesson 3: Evaluation of the Respiratory System Lesson Objectives • Explain how to collect a focused history related to the respiratory system • Undertake a physical examination of the respiratory system • Describe how to document a respiratory system assessment Basic Principles of Critical Care Training I Evaluation of the Respiratory System
- 6. Components of the Gradian CCV SystemLesson 3: Evaluation of the Respiratory System Key Concepts • Inspection • Percussion • Palpation • Auscultation Basic Principles of Critical Care Training I Evaluation of the Respiratory System
- 7. Components of the Gradian CCV SystemEvaluation of the Respiratory System Respiratory Assessments A thorough assessment consist of… • Inspection • Percussion • Palpation • Auscultation • Comprehensive health history Basic Principles of Critical Care Training I Evaluation of the Respiratory System
- 8. Components of the Gradian CCV SystemEvaluation of the Respiratory System Comprehensive Health History Determine chief complaints or respiratory symptoms: • Cough • Sputum production • Difficulty breathing • Chest pain • Exhaustion on exertion • Fever Basic Principles of Critical Care Training I Evaluation of the Respiratory System
- 9. Components of the Gradian CCV SystemEvaluation of the Respiratory System Comprehensive Health History Determine elements of patient history related to symptoms: • Chronic illness • Medications • Cigarette / tobacco use • Occupational history • Past medical / surgical history related to respiratory disease Basic Principles of Critical Care Training I Evaluation of the Respiratory System
- 10. Components of the Gradian CCV SystemEvaluation of the Respiratory System Physical Examination Ensure patient privacy before beginning a physical assessment 1) Inspection • Posture and breathing pattern (use of accessory muscles of breathing, retraction) • Added sounds (wheezing, stridor) • Chest deformity • Respiratory rate • SpO2 • Cyanosis Basic Principles of Critical Care Training I Evaluation of the Respiratory System
- 11. Components of the Gradian CCV SystemEvaluation of the Respiratory System Respiratory Rate Normal respiratory rate is dependent on age • Tachypnea – above normal rate • Bradypnea – lower than normal rate • Apnea – no breaths • Orthopnea – difficulty in breathing with change of position (e.g., laying down) Basic Principles of Critical Care Training I Evaluation of the Respiratory System Age range Normal respiratory rate 0-12 months 30-60 breaths/min 1-3 years 24-40 breaths/min 4-5 years 22-34 breaths/min 6-12 years 18-30 breaths/min 14 years 14-26 breaths/min Adult 12-16 breaths/min Note: agonal breath / gasps are not considered breaths and breathing should be supported, as you would apnea
- 12. Components of the Gradian CCV SystemEvaluation of the Respiratory System Cyanosis • Late sign of hypoxia as it indicates SpO2 < 85% Basic Principles of Critical Care Training I Evaluation of the Respiratory System
- 13. Components of the Gradian CCV SystemEvaluation of the Respiratory System Physical Examination Ensure patient privacy before beginning a physical assessment 2) Palpate • Tenderness • Symmetry • Crepitus • Chest expansion Basic Principles of Critical Care Training I Evaluation of the Respiratory System
- 14. Components of the Gradian CCV SystemEvaluation of the Respiratory System Physical Examination Ensure patient privacy before beginning a physical assessment 3) Auscultation Performed with a stethoscope on upper, middle, and lower areas of lungs, both anteriorly and posteriorly • Listen for presence or absence of breath sounds and other sounds (crackles, rhonchi) • Breath sounds are either bronchiole, bronchovesicular, or vesicular Basic Principles of Critical Care Training I Evaluation of the Respiratory System