Lesson 1Focused respiratory exam: breath sounds, work of breathing, accessory muscle use, pulse oximetry, end-tidal CO2 interpretation, and peak flow when feasibleGives a structured breathing check for complex patients, with looks, feels, and listens. Stresses effort, extra muscle work, pulse ox limits, EtCO2 wave reads, and peak flow if safe and doable.
Assessing respiratory rate, pattern, and effortInspection for accessory muscle use and postureSystematic lung auscultation and key findingsPulse oximetry limits and artifact recognitionEtCO2 values and waveform interpretation in COPDUsing peak flow to gauge obstruction severityLesson 2Airway escalation: when to use BVM, supraglottic airway, or perform RSI—drug selections, preoxygenation, and rapid sequence technique in respiratory failureWhen to step up from basic airway to BVM, supraglottic, or RSI in breathing failure. Reviews preoxygenation, drug picks, doses, and quick sequence method, focusing on COPD and overdose body responses.
Indicators for BVM support and optimisationChoosing and placing supraglottic airwaysWhen to proceed to RSI in respiratory failurePreoxygenation strategies in COPD and obesitySedative and paralytic choices and dosingPost-intubation ventilation and confirmationLesson 3Rapid history and scene clues: medication lists, smoke/odor, witness accounts, and assessment of mental statusGets quick, aimed history and uses scene hints to spot COPD, overdose, or mixed issues. Covers med lists, pill packs, smells, gear, witness tales, and mind state to steer early treatments.
Primary survey and immediate life threatsKey questions for bystanders and caregiversInterpreting medication lists and pill bottlesEnvironmental clues: smoke, chemicals, paraphernaliaAssessing baseline versus new mental status changeIntegrating scene clues into working diagnosisLesson 4Monitoring and transport considerations: ventilator vs spontaneous breathing, continuous capnography, and pre-notification of receiving facilityHandles monitoring and transport plans for ventilated or natural breathing patients. Talks continuous capnography, ventilator versus BVM aid, positioning, destination choice, and pre-notice to ready the facility.
Continuous SpO2 and EtCO2 during transportManaging patients on transport ventilatorsWhen to use BVM versus spontaneous breathingPositioning and securing airway and tubingChoosing destination and level of receiving careEffective pre-notification and handoff reportsLesson 5Naloxone use for suspected opioid overdose: dosing strategies, routes (IV/IM/IN), titration to avoid acute withdrawal, and monitoringReviews naloxone drug action, triggers, and risks in suspected opioid overdose with breathing slowdown. Covers IV, IM, IN paths, dose plans, step-up to good breathing, and watch for return or withdrawal.
Recognising opioid toxidrome in the fieldNaloxone mechanism, onset, and durationChoosing IV, IM, or IN route for naloxoneInitial dosing and careful titration strategiesManaging acute withdrawal and agitation risksPost-reversal monitoring and transport needsLesson 6Differentiating COPD exacerbation, cardiogenic pulmonary oedema, aspiration, and opioid/sedative overdose—key exam and device findingsHow to tell COPD flare, heart-linked lung fluid, aspiration, and opioid or sedative overdose apart. Stresses targeted check, lung sounds, mind state, and gear data like EtCO2, ox, and ECG.
Typical history and triggers in COPD exacerbationSigns of cardiogenic pulmonary oedema in the fieldClues to aspiration and airway contaminationRecognising opioid and sedative overdose patternsUsing lung sounds, EtCO2, and SpO2 to differentiateRole of ECG, blood pressure, and jugular veinsLesson 7Bronchodilator therapy: beta-agonists, anticholinergics, dosing, routes, and nebuliser vs MDI considerationsBronchodilator choices for COPD and asthma mix in breathing failure. Reviews beta-agonists and anticholinergics, triggers, risks, doses, paths, and practical diffs between nebulisers and MDIs with spacers.
Short-acting beta-agonists: agents and dosingAnticholinergic bronchodilators and combinationsNebuliser setup, flow rates, and timingMDI with spacer: technique and coachingAdverse effects and monitoring during treatmentWhen to repeat or escalate bronchodilator therapyLesson 8Oxygen and ventilation strategies: titration targets for COPD, indications for high-flow nasal cannula, NIV (CPAP/BiPAP) settings and contraindicationsOxygen step-up aims in COPD, device choices, and triggers for high-flow nasal cannula and NIV. Reviews CPAP/BiPAP setup, start settings, fixes, and main risks in unstable patients.
SpO2 and PaO2 targets in COPD and CO2 retainersChoosing nasal cannula, mask, or Venturi devicesIndications and setup for high-flow nasal cannulaInitiating CPAP and BiPAP: starting pressuresContraindications and complications of NIV useTroubleshooting mask leaks and patient intoleranceLesson 9Adjunct medical therapy: systemic corticosteroids (dosing and timing), magnesium, and diuretics for suspected cardiogenic pulmonary oedemaTriggers, doses, and timing of body-wide steroids and magnesium in COPD or asthma mix. Reviews diuretic picks and doses for suspected heart-linked lung fluid, with risks and watch needs.
Indications for systemic corticosteroids in COPDCommon steroid agents, doses, and onset timesUse of IV magnesium in severe bronchospasmRecognising cardiogenic pulmonary oedema in the fieldDiuretic choices, dosing, and contraindicationsMonitoring response and adverse medication effects
