Respiratory distress

Jason Oost, Mohamud Daya

Research output: Chapter in Book/Report/Conference proceedingChapter


Respiratory distress is a common chief complaint in EMS, and initial evaluation should be focused on preserving life and determining the need for an immediate intervention such as non-invasive positive pressure ventilation, bag-valve-mask ventilation, or endotracheal intubation. Once this evaluation is completed, focus should be placed on identifying a provisional underlying cause for the respiratory distress. Respiratory distress may be caused by a primary pulmonary problem (e.g. asthma or COPD), a cardiac problem (e.g. acute coronary syndrome or congestive heart failure), an infectious problem (e.g. pneumonia or sepsis), or another problem for which the respiratory system is compensating (e.g. metabolic acidosis from an overdose or diabetic ketoacidosis). In general, treatment should include titrated oxygen and continuous monitoring of cardiac rhythm, SpO2,and EtCO2 while ensuring timely transport. In stable situations, the emphasis should be on avoiding unnecessary treatments and resisting the urge to give multiple medications in an undirected fashion. Prehospital focused chest ultrasound can assist with diagnosis and help guide therapeutic interventions.

Original languageEnglish (US)
Title of host publicationClinical Aspects of EMS
Number of pages9
ISBN (Electronic)9781118990810
ISBN (Print)9781118865309
StatePublished - Feb 12 2015


  • Asthma
  • Chronic obstructive pulmonary disease
  • Endotracheal intubation
  • Heart failure
  • Non-invasive positive pressure ventilation
  • Pneumonia
  • Pneumothorax
  • Pulmonary edema
  • Pulmonary embolus

ASJC Scopus subject areas

  • General Medicine


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