Respiratory – Key Considerations




Acute Asthma Acute Pulmonary Edema Upper Airway Obstruction/Stridor


Respiratory: Acute Asthma

Acute Asthma Key Points/Considerations
• Remember, “All that wheezes is not asthma!” Consider allergic reaction, airway
obstruction, pulmonary edema, COPD exacerbation
• A total of 3 doses of Albuterol may be administered by pre-hospital providers, prior
to consulting Medical Control Physician
• Epinephrine should be used if patient is in severe distress and tidal volume is so
small that nebulized medications can’t work
• If an ALS provider has administered any medications they must consult a physician
prior to allowing a patient to RMA or before sending the patient BLS

Respiratory: Acute Pulmonary Edema

Key Points/Considerations
• All patients with rales do not have pulmonary edema — consider the possibility of
pneumonia or chronic obstructive pulmonary disease (COPD) exacerbation
• May administer Nitroglycerin while preparing to establish vascular access. Contact
Medical Control Physician for continued Nitroglycerin administration if no vascular
• Nitroglycerin paste TD only if unable to administer orally

Respiratory: Upper Airway Obstruction/Stridor

Key Points/Considerations
• Consider using smaller than usual ET tube