MICA · CARE LEARNING NOTES
Observe, keep care safe and communicate
Dyspnoea is a subjective symptom; severity is judged from the whole patient. The paramedical role combines observation, safe initial actions and early medical escalation without waiting for a definite cause.
Recognise respiratory distress
Observe ability to speak, breathing effort, rate, unusual sounds and consciousness. Exhaustion, cyanosis, stridor, chest pain, collapse or rapid deterioration require immediate assistance. An apparently acceptable saturation is insufficient reassurance: the oximeter measures neither ventilation nor carbon dioxide. Slowing breathing in an exhausted patient can be concerning.
[1][2]Provide safety and suitable positioning
Stop exertion, stay with the patient and help them adopt a position that eases breathing if circulation and consciousness allow. Clear access for the emergency team. Assess the airway and apply first aid manoeuvres within training. Do not make a patient in respiratory distress walk to the treatment room or equipment.
[1]Oxygen and medical assessment
Check the current device, its connection and the agreed target. Oxygen treats hypoxaemia; it is not an automatic treatment for every sensation of breathlessness. In a life-threatening emergency, apply the emergency protocol immediately and call for help without waiting for administrative formalities. Hypercapnia risk and blood gases may change the target: do not systematically seek maximal saturation.
[2][1]Describe what the patient can still do: speak, lie flat or move. Exhaustion, less effective breathing or drowsiness are concerning even if agitation subsides. New breathlessness must not immediately be attributed to anxiety; report onset, associated pain and treatments already given.
- Stay with an unstable patient while arranging help and monitoring.
Hand over without premature diagnosis
Report onset, trigger, course, associated symptoms, known respiratory disease and recently administered treatment. Include respiratory rate, saturation with delivery device, pulse, blood pressure and consciousness. Do not initially attribute the complaint to anxiety. Reassess effort and alertness after each intervention; an improved number alone does not remove the need to assess clinical deterioration.
[1][2]A learning situation
FICTIONAL SITUATION · REFLECTION WITHOUT A SCORE
Fictional situation: after a procedure, a patient speaks in single words, sweats and struggles to breathe. The screen shows saturation within her usual target.
Does the reading allow the call to be delayed?
Read the reasoning
No. Difficulty speaking and increased breathing effort suggest possible distress despite the reading. Call the appropriate team immediately, remain with the patient, position according to tolerance and begin ABCDE. Check signal and delivery device in parallel; report the observed signs and follow reassessment instructions and the emergency protocol.
References and scope
- The ABCDE Approach ↗
- BTS guideline for oxygen use in adults in healthcare and emergency settings (2017) ↗
Original documentary teaching summary for adult care. Procedures and medicines depend on professional competence, prescription and institutional procedures. International references do not establish an Algerian protocol. Independent human scientific review remains to be confirmed.