Respiratory distress

Respiratory distress is a common chief complaint encountered by EMS, and initial evaluation should be focused on preserving life and determining the need for an immediate intervention, such as supplemental oxygen, noninvasive positive-pressure ventilation, basic airway management (bag-valve-mask ventilation), or advanced airway management (supraglottic airway placement or endotracheal intubation). Once this evaluation is completed, the focus should be placed on identifying the likely underlying etiology of the respiratory distress. Respiratory distress may be caused by a primary pulmonary problem (e.g., asthma, chronic obstructive pulmonary disease, pneumothorax), a cardiovascular issue (e.g., acute coronary syndrome, heart failure, pulmonary embolism), an infectious problem (e.g., pneumonia, sepsis), or another condition for which the respiratory system is compensating (e.g., metabolic acidosis or anemia). Point-of-care ultrasound is an evolving technology that may assist with diagnosis and help guide therapeutic interventions. General treatment should include titrated oxygen and continuous cardiac rhythm monitoring, pulse oximetry, and waveform capnography while ensuring timely transport. In stable situations, the emphasis should focus on avoiding unnecessary treatments that may be harmful.