ABCs and Vitals
General
- Speech
- Posture
- Work of breathing (accessory muscles, RR and depth, HR and rhythm, diaphoresis, level of comfort, level of consciousness)
- Signs of obstruction or impending respiratory exhaustion/failure
- Tracheal tug (downward descent of trachea with inspiration)
- Decreasing LOC
- Irregular or decreasing amplitude of pulse
- Pulsus paradoxus (measure BP)
- Respiratory alternans, or paradoxical movement of diaphragm
- Cyanosis (central – late and ominous finding, peripheral)
- Signs of bronchospam
- Wheeze
- Prolongation of expiratory phase
- Quiet chest = BAD
- Exacerbation factors
- Evidence of upper and lower respiratory tract infections
- Pneumothorax
- Allergies
- Measure peak flow and/or spirometry