Respiratory Distress, h/o Asthma part 2


• Scene – albuterol, atrovent, vs, ekg, cbg

• En route – no transport

• Hospital – none


• Response to treatment – patient cleared up after first duo neb. He stated that he felt better and could take a deep breath now.

• Disposition – patient and family were advised of risks and of refusing transport.


Elliot Williams, Paramedic Woodburn Ambulance


David M. Spiro, MD, MPH Professor of Pediatrics University of Arkansas Medical Center


• Asthma exacerbation

Differential Diagnosis

• Asthma exacerbation

• Pneumonia

• Foreign body (less likely due to age)

• Bronchiolitis

• Pneumonitis

Patient Workup History

• Patient states – He went to bed feeling good, but woke up at about 0200 with difficulty breathing and a dry throat.

• Caregiver states – he has seasonal allergies and every fall he has problems with breathing.

Physical Exam

• Patient upright and walking; appears calm, but has wheezing and dry throat.

• EKG – SR

• GCS – 15

• CBG – 104

Editor’s Notes

This child seems to be in mild to moderate respiratory distress. No verbal response due to the neb treatment, however note the increased respiratory rate and retractions. In areas where steroids are allowed in the prehospital setting, starting them at this junction would be reasonable. The family refused treatment in this case after a thorough discussion of risks of non-transport.

Suggested References

IU School of Medicine and Indianapolis EMS Target Childhood Asthma with Paramedic Housecalls

Pediatric asthma

Asthma Care Quick Reference: Diagnosing and Managing Asthma


• Gender: Male

• Age: 12 years

• Height: Not Available

• Weight: Not Available


• Temperature: Not Available

• Blood Pressure: 125/68

• Heart Rate: 89

• Respiratory Rate: 24

• Pulse Oximetry: 98% RA

Signs and Symptoms

Dry throat; difficulty breathing

History Medical

• PMH: Asthma

• Alleriges: None

• Dispatch info: Asthma attack


• Lives with his uncle Medications

• Ventolin

Related videos