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, including looking, feeling, and listening. Stresses effort of breathing, extra muscle use, pulse oximetry, EtCO2 wave reading, and peak flow when possible and safe.
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 failureDetails when to step up from basic airway moves to BVM, supraglottic airway, or RSI in breathing failure. Reviews preoxygenation, drug picks, doses, and rapid sequence method, with focus on COPD and overdose body workings.
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/odour, witness accounts, and assessment of mental statusFocuses on getting a quick, aimed history and using scene hints to spot COPD, overdose, or mixed issues. Covers med lists, pill bottles, smells, gear, witness stories, and mind state to guide early treatment choices.
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 planning for ventilated and natural breathing patients. Talks about steady capnography, ventilator versus BVM aid, positioning, destination pick, and pre-notification to ready the receiving place.
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 workings, needs, and warnings in suspected opioid overdose with breathing slowdown. Covers IV, IM, and IN ways, dosing plans, titration to good breathing, and watching 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 findingsDetails how to tell apart COPD flare-up, heart-linked lung water, aspiration, and opioid or sedative overdose. Stresses focused check, lung sounds, mind state, and device data like EtCO2, oximetry, and ECG findings.
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 considerationsCovers bronchodilator choices for COPD and asthma mix in breathing failure. Reviews beta-agonists and anticholinergics, needs, warnings, doses, and ways, plus real differences 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 contraindicationsCovers oxygen titration goals in COPD, choice of delivery tools, and needs for high-flow nasal cannula and NIV. Reviews CPAP/BiPAP setup, starting settings, fixing issues, and main warnings 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 oedemaExplores needs, doses, and timing of systemic corticosteroids and magnesium in COPD or asthma mix. Reviews diuretic choice and dosing for suspected heart-linked lung water, including warnings and monitoring 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
