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Protocol # 6 by Adnan ahmed
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BreathingThe process of respiration, during which air is inhaled
into the lungs through the mouth or nose due to musclecontraction, and then exhaled due to muscle
relaxation.
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Second PageStructure
Of Human Respiratory system
1.Nose & Mouth.2.Pharynx.3.Larynx.4.Trachea.5. Bronchi.
6. Bronchioles.7. Lungs.8. Alveoli.
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Difficulty in breathing may occur due to:
Problems in the lungs:
Acute pulmonary oedema:Pulmonary edema is a condition in which
fluid accumulates in the lungs.
Asthma: Respiratory condition causedby narrowing of the airways.
Congestive heart failure:Congestive heart failure (CHF) is acondition in which the heart's function
as a pump is inadequate to deliveroxygen rich blood to the body.
Continue......
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Emphysema (COAD): ChronicObstructive Airways Disease. Chroniclung disease in which there is permanent
destruction of alveoli.
Pneumonia :It is an inflammation ofthe lung, usually caused by an infection
Pulmonary embolus: blockage in alung artery due to blood clot in lungs.
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Problems in the Upper Airway:
Allergic reaction:It affects respiratorysystem.
Choking: Partial or completeobstruction of the airway it can be due to
foreign body .
Croup : a respiratory problem thatoccurs mainly in children due to aninfection in airway.
Epiglottitis: It is inflammation of theepiglottis - the flap that sits at the base of
the tongue, which keeps food from goinginto the trachea (windpipe).
Tracheitis: Is a common infection thatis caused by bacterial buildup in the
trachea and can cause airway obstruction
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Problems NOT in the Lungs or Airway:Cardiac arrest: Cardiac arrest is the sudden loss of cardiac function, when theheart abruptly stops beating.
Diabetic ketoacidosis : High blood glucose with the presence of ketones inthe urine and blood stream, often caused by taking too little insulin or during
illness.
Drug/substance abuse: When a drug wears off, very large doses can cause aperson to stop breathing and result in death.
Fits: Fitts causes the body and brain to swell and this can lead breathingproblem.
Heart attack: A heart attack is when low blood flow causes the heart to starvefor oxygen. Heart muscle dies or becomes permanently damaged.
Hyperventilation syndrome: HVS is a respiratory disorder, psychologically orphysiologically based, involving breathing too deeply or too rapidly
Respiratory Arrest :It is a medical condition in which a person has stoppedbreathing, though the heart is still beating.
Stroke:Some of the signs of major stroke are difficulty in breathing
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Case Entry Questions:
3. Okay, tell me exactly what happened.
Some important terminologies used by attendents are:Shortness of breath.
Breathlessness.
Difficulty breathing.
Dyspnea.
Hypoventilation.
Hyperventilation.
Oxygen Saturation.
Pulmonary.
Tracheotomy.
Ventilator.
Stoma.Cyanosis.
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Key Questions:
1. Is s/he completely alert (responding appropriately)?
2. Does s/he have difficulty speaking (crying)between beaths?
3. Is s/he changing colour?a. (Yes)Describe the colour change.
Continue.....
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4. Is s/he clammy (cold sweats)?5. Does s/he have astma?
a. (Yes)Does s/he have a prescribed inhaler?
i. (Yes)Has s/he used it yet?6. (Tracheostomy blockage)Does s/he any special
equipment or instructions to treat this?a. (Yes)Have they been used?
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NormalBreathing Rate
Age Breaths per 10 sec.
New born 5 -10
6 12 months
4 5
1 5 yrs 3 5
6 12 yrs 2 4
Above 12 yrs 2 - 3
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PostDispatch Instructions
a. (Patient medication requested and alert)Remind her/him to do what her/his doctor has instructed for
these situations.
b. (Prescribed inhaler not yet used)Advise her/histo use the inhaler now.
c. (Special equipment/instructions not yet used)Advise her/him to use that treatment now.d. Monitor and maintain patient's airway, especially if patient is
nauseous or vomiting. Keep airway clear.
b. Calm and reassure the patient. Tell the patient to relax and
slow their breathing,
c. Do not place pillow under the patients head.d. Do not give food or drink.
e. Let patient assume position of comfort (usually sitting-up).f. Keep the patient warm (maintain body temperature).
g. Gather or list the patient's medication for the doctor.
h. Call back if the patient's condition changes before help
arrives.
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41%
36%
23%
Gender Wise Report
Male
Female
C il er
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0
200
400
600
800
1000
1200
1400
1600
1800
2000
Echo Delta Charli
52
1978
1346
Level Wise Report
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70
180
204
205
397
424
468
0
537
445
446
0 100 200 300 400 500 600
P.E.C.H.S
Baldia
Clifton
Site
North Nazimabad
North Karachi
Gulberg
Gulshan
Korangi
Bin Qasim
Malir
Station Wise Report
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2097
1056
2 1
209
110
500
1000
1500
2000
2500
Hosp - Hosp Home - Hosp Hosp - Home Roadside - Hosp Already
transfered/Exp
First aid
Origin Wise Report
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Best Experiances:Call No.1:
Date: 2-2-11 EC#: 105819 Shift : Morning
Call duration: 7 min Area: Korangi Code: 6-D-2P.Name: Uzma Age: 20 y Breaths: 16/10 secCondation: Concsious but hyperventilation patient
Call No.2:
Date: 15-2-11 EC#: 109843 Shift : Morning
Call duration: 12 min Area: Muzafarabad Code: 6-D-2
P.Name: Haseena Age: 5y Breaths: 10/10 secCondation: Concsious but dificulty in speaking between breaths
with gasping voices.
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Thank You
By: Lubna Haseeb