Breathing Problems
Medical History
Do you have a cough?
Have you had TB?
Is Cough thick?
Is it Yellow or Bloody?
Are you Short of Breath?
2
Physical Exam
Clean technique when possible
Vital Signs
Blood Pressure
Pulse
Breathing
Oxygen Saturation
Temperature
3
Assess Patient with Vital Signs
Blood Pressure
120 systolic( pumping force through
body)
80 diastolic ( heart resting after
pumping)
Heart Rate or Pulse in one minute
normal 60 to 100 beats per minute
4
Understanding Vital Signs
Blood pressure:
Pressure or force of blood through body
Pulse
Is how many time the heart beats in 1 minute
Normal is between 60 and 100 beats per minute
Respiration
Is how many breaths in 1 minute normally 12-20
Oxygen level of greater than 90% is normal
Temperature
Temperature of greater than 101F or 39C is important
5
How to take Blood Pressure
Apply the cuff
Feel for pulse
Close the valve
Pump up gauge
Open slowly
Record first and last beat
See Video or demonstration
6
Range of Normal Blood Pressure
and Pulse
Normal Ranges
Age
Minimum BP
Pulse
Adult
90
60-100
Child
80
60-120
Infant
60
80-160
Newborn
60
80-160
7
PULSE
Feel for Pulse to Know the Pressure the Heart
is Pushing Blood through Your Body.
Three important places to feel for Pulse
Neck or Carotid Pulse
Wrist or Radial Pulse
Groin or Femoral
Normal Depends on Age see chart
8
Heart Rate or Pulse
Check for a Pulse
Neck
Groin
Wrist
Count the number of beats in 1 minute
Counting Respirations or Breaths
Respiration are the Number of Breaths in 1 minute
Count the Rise and Fall of the Chest in 1 Minute
Normal is 12 to 20 breaths in a minute
Breathing
Rate should be More than 12 and Less
than 20 breaths in one minute and pulse
oximeter Greater than 90%
Put Pulse Oximeter onto index finger
and wait for the numbers to appear on
screen.It is important to take at last 3
readings
11
How to Use Pulse Oximeter
Thursday, October 20, 11
Measure Body Temperature
Teaching
Seek Immediate Help!
Low blood pressure and Fast heart rate
Blood Pressure less than 90 or
Heart rate greater than 120
Difficulty breathing and Pulse Oximeter
Oximeter less than 90%
Uncontrolled bleeding
After pressure and elevation
15
If you have Normal Vital Signs with Productive
Cough and O2 level Greater than 90%
Diagnosis is Bronchitis or Early Pneumonia
Treatment
Adult
Amoxicillin 500mg
Give one in morning and once in evening for 5 to 7days
Pediatric
80mg/kg/day
divide the dose 1/2 morning and 1/2 evening for 5 to 7days
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Pneumonia
17
Microscope
18
X-Ray of Pneumonia
19
Signs of Severe Pneumonia
Signs of Breathing Problems
Retractions ribs sunken
Rapid breathing Greater than 20
Use of all muscles of breathing
Blue color lips and fingers
Oxygen Saturation less than 90
See Pictures of each of these signs
20
Severe Dangerous Breathing Problems
Extra muscles of chest to Breath
More dangerous when using muscles of
chest and neck get help!
Children work so hard to breathe
that the chest caves inward
Danger get help!
Children and Adults get tired from
breathing so hard they will stop
Important sign if they get sleepy or
confused get help!
Once the body looses oxygen lips and
fingers will turn BLUE
SIGNS OF TROUBLE
Breathing Hard
Use of Extra
Muscles to Breath
Chest pulls inward
Sitting Forward
Anxious
Treatment of Severe Pneumonia
Intramuscular (IM) or Intravenous (IV) injection
of antibiotics then switch to oral if improved
Adult
Ceftriaxone 1000mg daily for 3 days
Pediatric dose
50mg/kg/day give a single dose IV or IM
Seek Help as Soon as Possible!
See Instruction Video on Intramuscular
Injection
27
Intramuscular Injection
See MODULE ON INJECTION
28
Intramuscular Injection
Give medicine into muscle with a needle
if very sick and get help
See video or demonstration on how
this is done
See video or demonstration
on how to measure dose based
on weight