Patient Assessment and Lung Sounds

Introduction

• Focus on patient assessment through lung sounds.
• Importance of recognizing lung sounds in cases of difficulty breathing.

Lung Sounds Overview

• Vital Signs & History: Vital signs, pulse oximetry, and patient history are important but lung sounds are crucial.

Types of Lung Sounds

Wheezing

• Mnemonic: AAC
  • Asthma
  • Anaphylaxis
  • COPD
• Key Points:
  • Chest tightness and productive cough are associated.
  • Cardiac wheezing possible, always do an EKG if wheezing is heard.
  • Anaphylaxis involves stridor, hives, and affects two or more body systems.

Rhonchi

• Description: "Junk" in the lungs, often due to infections or inflammation.
• Associated Condition: Pneumonia (unilateral or bilateral, often with fever, green/yellow sputum).

Rales

• Commonly Linked to:
  • Congestive Heart Failure (CHF): Bilateral rales, pink frothy sputum, JVD, edema, pulmonary edema.
  • Pneumonia: Early onset may present with rales, usually green/yellow sputum.

Lung Sound Variations

Diminished Lung Sounds

• Could indicate:
  • Fluid overload or severe bronchial tightness.
  • Pulmonary embolism (can present with clear lung sounds).
  • Pneumothorax (unilateral diminished sounds).
• Key Symptoms: JVD, tracheal deviation, mediastinal shifts.

Absent Lung Sounds

• Potential Causes:
  • Tension pneumothorax (unilateral, severe hypotension).
  • Extreme bronchial tightness in AAC conditions (bilateral).

Important Considerations

Unilateral vs. Bilateral Lung Sounds

• Unilateral: Often indicates a localized issue such as pneumothorax or unilateral pneumonia.
• Bilateral: Suggests systemic conditions like CHF or severe asthma/COPD/anaphylaxis attacks.

Conclusion and Additional Resources

• Understanding and identifying lung sounds is critical for effective patient assessment.
• Encourage continued learning, with resources available for EMT and paramedic training including a video study course.
• Call to Action: Engage with the content and consider courses for better understanding and preparation for exams.