As winter approaches, so too does cold and flu season. This time of year usually marks an uptick in emergency room visits and EMS responses, many of which involve a respiratory disorder. And any respiratory emergency can lead to a critical suction scenario. So, to prepare for the long winter ahead, let’s examine some potential winter suction scenarios you may encounter as we await the coming of Spring.
Winter and the Respiratory Tract
Winter naturally ushers in a plethora of respiratory ailments, any of which can lead to complications, especially among the elderly. As temperatures drop, people tend to hunker inside, leading to higher rates of contagion. The drier winter air reduces moisture within our respiratory tracts, inhibiting the ability of our mucous membranes to filter out contaminants. And exposure to cold can exacerbate these conditions.
Some common winter respiratory illnesses include:
- Influenza (Flu)—The symptoms of the flu are similar to those seen with the common cold, but more severe. They include runny nose, nasal congestion, fever with chills, body aches, fatigue, exhaustion, stomachache, and vomiting.
- Pneumonia—Pneumonia can be viral or bacterial in origin. The alveoli become inflamed and fill with fluid, which diminishes air exchange. Symptoms include fever, cough, reduced appetite, rapid breathing, retractions, and flaring.
- Bronchitis—Bronchitis is a respiratory illness caused by many different viruses. It causes inflammation in the bronchioles, which swell and fill with mucus. Bronchitis presents with similar symptoms to the cold but, like influenza, its symptoms are more severe. They include wheezing, rapid shallow breathing, and respiratory distress. Retractions and nasal flaring are also common.
These illnesses can be especially serious in patients who are already immunocompromised (such as cancer patients) and the elderly, who typically have underlying medical conditions.
As with any respiratory ailment, if left untreated, the patient can suffer from airway obstruction, requiring effective suction to restore airway patency. Mucus and vomit can clog the airway, especially in patients who are febrile and lethargic. The elderly are especially at risk. Prior strokes may impede the patient’s ability to swallow or clear his or her airway. Those who live alone may not have adequate care or be unable to get themselves to a hospital for early treatment. And the natural progressions of aging, such as the inability to regulate body temperature, may cause delays in treatment, leading to sepsis and multiple organ dysfunction syndrome.
When responding to patients suffering from respiratory ailments, be sure to include your portable suction unit along with other ALS equipment. Keep a suction unit stowed in the airway bag, so it is always available for critical suction scenarios. And when responding to geriatrics during the winter months, be sure to maintain a high index of suspicion for potential respiratory disorders. These patients are especially vulnerable.
The Trauma of Winter
The winter months can also mean an increase in certain types of traumatic injuries. Winter sports such as skiing, ice skating, and sledding not only expose participants to the elements, but also can lead to serious bodily injury; many of these injuries can result in a winter suction scenario.
High-speed sports, such as skiing and sledding, can result in crashes, causing head injuries. As with any head injury, a diminished level or total loss of consciousness can lead to airway compromise. These patients are unable to protect their airways, and are at risk for partial and total obstructions. Vomit, mucus, and blood must be cleared from the airway immediately to prevent hypoxia, which means your portable suction unit must be close by.
When responding to traumatic injuries this winter, be sure to carry along your suction unit. Some units are small enough to fit neatly in the trauma bag, ensuring their availability on every trauma call.
Winter, like any season, poses its own challenges for EMS professionals. So, as the cold season arrives, be sure you are prepared, especially for the next winter suction scenario.