Aralin 1Focused respiratory exam: breath sounds, work of breathing, accessory muscle use, pulse oximetry, end-tidal CO2 interpretation, at peak flow kapag posibleNagbibigay ng structured respiratory exam para sa complex patients, kabilang ang inspection, palpation, at auscultation. Binibigyang-diin ang work of breathing, accessory muscle use, pulse oximetry, EtCO2 waveform interpretation, at peak flow kapag posible at ligtas.
Assessment ng respiratory rate, pattern, at effortInspection para sa accessory muscle use at postureSystematic lung auscultation at key findingsLimits at artifact recognition ng pulse oximetryEtCO2 values at waveform interpretation sa COPDPaggamit ng peak flow upang sukatin ang obstruction severityAralin 2Airway escalation: kailan gumamit ng BVM, supraglottic airway, o gumawa ng RSI—pagpili ng gamot, preoxygenation, at rapid sequence technique sa respiratory failureNagdedetalye ng kailan mag-escalate mula sa basic airway maneuvers patungo sa BVM, supraglottic airway, o RSI sa respiratory failure. Binubuwisan ang preoxygenation, pagpili ng gamot, dosing, at rapid sequence technique, na may diin sa COPD at overdose physiology.
Indicators para sa BVM support at optimizationPagpili at paglalagay ng supraglottic airwaysKailan magpatuloy sa RSI sa respiratory failurePreoxygenation strategies sa COPD at obesityPagpili at dosing ng sedative at paralyticPost-intubation ventilation at confirmationAralin 3Rapid history at scene clues: medication lists, smoke/odor, witness accounts, at assessment ng mental statusNakatuon sa pagkuha ng rapid, targeted history at paggamit ng scene clues upang matukoy ang COPD, overdose, o mixed pathology. Sumasaklaw sa medication lists, pill bottles, odors, paraphernalia, witness accounts, at mental status upang gabayan ang early treatment decisions.
Primary survey at immediate life threatsKey questions para sa bystanders at caregiversPag-interpret ng medication lists at pill bottlesEnvironmental clues: smoke, chemicals, paraphernaliaAssessment ng baseline versus new mental status changePag-iintegrate ng scene clues sa working diagnosisAralin 4Monitoring at transport considerations: ventilator vs spontaneous breathing, continuous capnography, at pre-notification ng receiving facilityTumatugon sa monitoring at transport planning para sa ventilated at spontaneously breathing patients. Tinatalakay ang continuous capnography, ventilator versus BVM support, positioning, destinasyon choice, at pre-notification upang ihanda ang receiving facility.
Continuous SpO2 at EtCO2 sa transportPamamahala sa patients sa transport ventilatorsKailan gumamit ng BVM versus spontaneous breathingPositioning at securing ng airway at tubingPagpili ng destinasyon at level ng receiving careEffective pre-notification at handoff reportsAralin 5Paggamit ng naloxone para sa suspected opioid overdose: dosing strategies, routes (IV/IM/IN), titration upang maiwasan ang acute withdrawal, at monitoringBinubuwisan ang naloxone pharmacology, indications, at contraindications sa suspected opioid overdose na may respiratory depression. Sumasaklaw sa IV, IM, at IN routes, dosing strategies, titration sa adequate breathing, at monitoring para sa recurrence o withdrawal.
Pagkilala sa opioid toxidrome sa fieldNaloxone mechanism, onset, at durationPagpili ng IV, IM, o IN route para sa naloxoneInitial dosing at careful titration strategiesPamamahala sa acute withdrawal at agitation risksPost-reversal monitoring at transport needsAralin 6Pagkakaiba ng COPD exacerbation, cardiogenic pulmonary edema, aspiration, at opioid/sedative overdose—key exam at device findingsNagdedetalye kung paano magkakaiba ang COPD exacerbation, cardiogenic pulmonary edema, aspiration, at opioid o sedative overdose. Binibigyang-diin ang focused exam, lung sounds, mental status, at device data tulad ng EtCO2, oximetry, at ECG findings.
Typical history at triggers sa COPD exacerbationSigns ng cardiogenic pulmonary edema sa fieldClues sa aspiration at airway contaminationPagkilala sa opioid at sedative overdose patternsPaggamit ng lung sounds, EtCO2, at SpO2 upang magkakaibaRole ng ECG, blood pressure, at jugular veinsAralin 7Bronchodilator therapy: beta-agonists, anticholinergics, dosing, routes, at nebulizer vs MDI considerationsSumasaklaw sa bronchodilator options para sa COPD at asthma overlap sa respiratory failure. Binubuwisan ang beta-agonists at anticholinergics, indications, contraindications, dosing, at routes, plus practical differences sa pagitan ng nebulizers at MDIs na may spacers.
Short-acting beta-agonists: agents at dosingAnticholinergic bronchodilators at combinationsNebulizer setup, flow rates, at timingMDI na may spacer: technique at coachingAdverse effects at monitoring sa treatmentKailan ulitin o mag-escalate ng bronchodilator therapyAralin 8Oxygen at ventilation strategies: titration targets para sa COPD, indications para sa high-flow nasal cannula, NIV (CPAP/BiPAP) settings at contraindicationsSumasaklaw sa oxygen titration targets sa COPD, pagpili ng delivery devices, at indications para sa high-flow nasal cannula at NIV. Binubuwisan ang CPAP/BiPAP setup, initial settings, troubleshooting, at key contraindications sa unstable patients.
SpO2 at PaO2 targets sa COPD at CO2 retainersPagpili ng nasal cannula, mask, o Venturi devicesIndications at setup para sa high-flow nasal cannulaPagbubukas ng CPAP at BiPAP: starting pressuresContraindications at complications ng NIV useTroubleshooting ng mask leaks at patient intoleranceAralin 9Adjunct medical therapy: systemic corticosteroids (dosing at timing), magnesium, at diuretics para sa suspected cardiogenic pulmonary edemaNag-eexplore ng indications, dosing, at timing ng systemic corticosteroids at magnesium sa COPD o asthma overlap. Binubuwisan ang diuretic selection at dosing para sa suspected cardiogenic pulmonary edema, kabilang ang contraindications at monitoring needs.
Indications ng systemic corticosteroids sa COPDCommon steroid agents, doses, at onset timesPaggamit ng IV magnesium sa severe bronchospasmPagkilala sa cardiogenic pulmonary edema sa fieldDiuretic choices, dosing, at contraindicationsMonitoring ng tugon at adverse medication effects
