Lesson 1Focused respiratory exam: breath sounds, work of breathin', accessory muscle use, pulse oximetry, end-tidal CO2 interpretation, an' peak flow when feasibleProvide a structured respiratory exam fi complex patients, includin' lookin', feelin', an' listenin'. Stress work of breathin', accessory muscle use, pulse oximetry, EtCO2 waveform readin', an' peak flow when feasible an' safe. Dis spot problems early.
Checkin' respiratory rate, pattern, an' effortLookin' fi accessory muscle use an' postureSystematic lung listenin' an' key findin'sPulse oximetry limits an' artifact spotEtCO2 values an' waveform readin' inna COPDUsin' peak flow fi gauge obstruction severityLesson 2Airway escalation: when to use BVM, supraglottic airway, or perform RSI—drug selections, preoxygenation, an' rapid sequence technique inna respiratory failureDetail when to step up from basic airway moves to BVM, supraglottic airway, or RSI inna respiratory failure. Review preoxygenation, drug choice, dosin', an' rapid sequence trick, wid stress on COPD an' overdose body work. Dis secure breathin'.
Signs fi BVM support an' optimizationChoosin' an' placin' supraglottic airwaysWhen to go to RSI inna respiratory failurePreoxygenation plans inna COPD an' obesitySedative an' paralytic choices an' dosin'Post-intubation ventilation an' confirmationLesson 3Rapid history an' scene clues: medication lists, smoke/odor, witness accounts, an' assessment of mental statusFocus on gettin' quick, targeted history an' usin' scene clues fi identify COPD, overdose, or mixed problems. Cover medication lists, pill bottles, odors, gear, witness talk, an' mental state fi guide early treatment choices. Dis uncover causes fast.
Primary survey an' immediate life threatsKey questions fi bystanders an' caregiversReadin' medication lists an' pill bottlesEnvironmental clues: smoke, chemicals, gearCheckin' baseline versus new mental state changeMixin' scene clues into workin' diagnosisLesson 4Monitorin' an' transport considerations: ventilator vs spontaneous breathin', continuous capnography, an' pre-notification of receivin' facilityAddress monitorin' an' transport plannin' fi ventilated an' spontaneous breathin' patients. Discuss continuous capnography, ventilator versus BVM support, positionin', destination choice, an' pre-notification fi prepare di receivin' facility. Dis ensure smooth ride.
Continuous SpO2 an' EtCO2 durin' transportHandlin' patients on transport ventilatorsWhen to use BVM versus spontaneous breathin'Positionin' an' securin' airway an' tubin'Choosin' destination an' level of receivin' careEffective pre-notification an' handoff reportsLesson 5Naloxone use fi suspected opioid overdose: dosin' strategies, routes (IV/IM/IN), titration to avoid acute withdrawal, an' monitorin'Review naloxone body work, signs, an' no-gos inna suspected opioid overdose wid breathin' down. Cover IV, IM, an' IN routes, dosin' plans, titration to good breathin', an' watchin' fi come back or withdrawal. Dis reverse danger quick.
Spot opioid toxidrome inna di fieldNaloxone mechanism, onset, an' durationChoosin' IV, IM, or IN route fi naloxoneInitial dosin' an' careful titration plansHandlin' acute withdrawal an' agitation risksPost-reversal watchin' an' transport needsLesson 6Differentiate COPD exacerbation, cardiogenic pulmonary edema, aspiration, an' opioid/sedative overdose—key exam an' device findin'sDetail how to tell apart COPD flare-up, heart-related lung water, aspiration, an' opioid or sedative overdose. Stress focused exam, lung sounds, mental state, an' device data like EtCO2, oximetry, an' ECG findin's. Dis clear di picture.
Typical history an' triggers inna COPD flare-upSigns of cardiogenic pulmonary edema inna di fieldClues to aspiration an' airway dirtSpot opioid an' sedative overdose patternsUsin' lung sounds, EtCO2, an' SpO2 fi differentiateRole of ECG, blood pressure, an' jugular veinsLesson 7Bronchodilator therapy: beta-agonists, anticholinergics, dosin', routes, an' nebulizer vs MDI considerationsCover bronchodilator options fi COPD an' asthma overlap inna respiratory failure. Review beta-agonists an' anticholinergics, signs, no-gos, dosin', an' routes, plus practical differences between nebulizers an' MDIs wid spacers. Dis open airways better.
Short-actin' beta-agonists: agents an' dosin'Anticholinergic bronchodilators an' combinationsNebulizer setup, flow rates, an' timin'MDI wid spacer: trick an' coachin'Bad effects an' watchin' durin' treatmentWhen to repeat or step up bronchodilator therapyLesson 8Oxygen an' ventilation strategies: titration targets fi COPD, indications fi high-flow nasal cannula, NIV (CPAP/BiPAP) settings an' no-gosCover oxygen titration targets inna COPD, choice of delivery devices, an' signs fi high-flow nasal cannula an' NIV. Review CPAP/BiPAP setup, initial settings, troubleshootin', an' key no-gos inna unstable patients. Dis support breathin' right.
SpO2 an' PaO2 targets inna COPD an' CO2 holdersChoosin' nasal cannula, mask, or Venturi devicesSigns an' setup fi high-flow nasal cannulaStartin' CPAP an' BiPAP: startin' pressuresNo-gos an' problems of NIV useTroubleshootin' mask leaks an' patient no-likeLesson 9Adjunct medical therapy: systemic corticosteroids (dosin' an' timin'), magnesium, an' diuretics fi suspected cardiogenic pulmonary edemaExplore signs, dosin', an' timin' of systemic corticosteroids an' magnesium inna COPD or asthma overlap. Review diuretic choice an' dosin' fi suspected heart-related lung water, includin' no-gos an' watchin' needs. Dis ease symptoms effective.
Signs fi systemic corticosteroids inna COPDCommon steroid agents, doses, an' onset timesUse of IV magnesium inna severe bronchospasmSpot cardiogenic pulmonary edema inna di fieldDiuretic choices, dosin', an' no-gosWatchin' response an' bad medication effects