Let’s dive into pneumonia. Pneumonia is essentially an infection in the lungs. It often starts as a simple upper respiratory infection and can progress deeper into the lung tissue, leading to pneumonia. When this happens, our lung function is impaired. This means our ability to bring in oxygen and remove carbon dioxide—our gas exchange—becomes compromised due to the infection.
It’s common for upper respiratory infections to develop into pneumonia, especially in certain populations. People with chronic conditions like COPD, renal failure, or diabetes are at higher risk. Those living in long-term care facilities, like nursing homes, or those with immune system disorders, such as cancer or HIV patients, are also more susceptible and can have worse outcomes.
Let’s go over the main signs and symptoms of pneumonia. Early on, patients might experience:
- Chest pain
- Shortness of breath
- Cough
- Fatigue (malaise)
- Body aches
- Fever
A cough with green or yellow sputum, along with shortness of breath and chest pain, is a classic sign. In the early stages, you might hear rails, which indicate the infection is still somewhat wet, meaning secretions are more easily mobilized.
As the infection progresses to the mid or later stages, you might hear more wheezing and rhonchi, with secretions becoming drier and harder to mobilize. The shortness of breath and chest pain can worsen.
Other indicators include an abnormal respiratory rate, heart rate, and blood pressure. In severe cases, patients can become hypotensive. Severe pneumonia can lead to respiratory depression or failure, characterized by:
- Severely low SpO2
- Tired, sluggish respirations
- Cyanosis
- Altered mental status
Now, let’s talk about treating pneumonia. First and foremost, BSI (body substance isolation) to protect yourself is crucial. For patient care, we focus on oxygen therapy. We want to get the patient’s oxygen levels up to 94% or higher. Utilize whatever oxygen delivery method is necessary to achieve this.
Don’t forget about end-tidal CO2 (EtCO2) monitoring. It provides a great picture of the patient’s lung and respiratory status. AEMTs and Paramedics should consider an EKG to check the heart condition.
We have tools like nebulizers (albuterol, DuoNeb) that help open the lungs. Albuterol acts on the beta-2 receptors, causing bronchodilation. Additionally, CPAP and BiPAP can be incredibly beneficial. They improve gas exchange by opening the alveoli, similar to how we treat heart failure patients.
Remember, these interventions help clear the infection and improve gas exchange in patients with severe pneumonia. Stay vigilant and always prioritize the basics: airway, breathing, and circulation.
