Example of edit made in “suggestion mode”. Summer is upon us, and it seems like only yesterday we were dealing with the winter woes of emergency medicine: traumatic injuries from winter sports, an onslaught of influenza as the temperatures plummeted, and the winter doldrums that can lead to depression and anxiety for those predisposed.

Trauma-related respiratory emergencies can be some of the most difficult patient scenarios to treat. Trauma comes in many forms: from blunt to penetrating to blast injuries involving any or many parts of the body. And when the trauma affects the respiratory system, whether through direct impact (oral or facial injuries) or indirectly (pneumothorax or hemothorax), your patient can teeter on the brink of survival.

Treating respiratory emergencies is never easy. And when they are compounded by trauma, they can be downright deadly. So, let's discuss what to look for when it comes to trauma-related respiratory emergencies.

As a paramedic, you know the most critical task you are called on to perform is managing the airway. Whether your patient is an asthmatic, struggling for breath; a pediatric suffering a partial blockage due to an inhaled object; or an unconscious trauma victim with a blood-clogged airway, the decisions you make and the actions you take will determine whether your patient lives or dies.

Take a deep breath. Now let it out slowly. Do you ever stop to think about the amazing physiological processes that take place within our bodies, each time we take a breath? Breathing is one of many bodily functions we take for granted—that is, until we are unable to breath. Something to think about the next time you treat an asthmatic or choking victim.

As an EMS professional, you know that the elderly make up a large percentage of your patients, especially if you work in one of the more common retiree zones (Florida or Arizona, for example). According to the CDC, that number is only increasing. In the last century, our country has seen unprecedented growth in the number of geriatrics. Longer life spans and aging Baby Boomers are the leading factors in this increase, and by 2030, elderly people are expected to account for roughly 20 percent of the U.S. population.¹ Which for you means that the number of geriatric patients you run on each year will only increase.

As an emergency responder, you know what a vital role training plays in job preparedness. You can’t predict what the next call will be, so you had better be ready for anything your community throws at you. Some calls are standard: the unresponsive patient, the elderly person having chest pain, or the child who fell off his bike, breaking his arm. These types of calls come in with such frequency, that training for them can seem redundant and unnecessary.

The man had been mowing the lawn when he collapsed under the intense, midday sun. You arrive on scene to find an elderly man, pulseless and apneic, in the front yard of a small house. The neighbors have gathered in a worried huddle, dogs are barking from behind a nearby fence, and all eyes are on you to immediately remedy the situation.

The patient was practically comatose by the time you arrived on scene. A gastric cancer patient, he had lost his ability to effectively swallow and had regurgitated once he arrived home from his chemotherapy treatment. As your partner flips open the airway bag, you attach the monitor and note a bradycardic rate of fifty-four. You set up for an IV while your partner cranks on the O2, only to realize the tank is empty. He dashes out to the truck for a replacement while you attempt the IV. Valuable seconds tick by. The patient is breathing on his own, yet gasping, and you fail to notice the remnants of vomit and bile rimming his mouth. With each passing minute, he inhales more of the acidic stomach contents lodged in his airway. His prognosis is quickly devolving.

When was the last time you intubated a patient? If you work in a busy metropolitan area, with high trauma rates or a large elderly population, intubations may be a regular occurrence. But for many emergency personnel, especially those assigned to slower stations, intubations are few and far between. Which makes it all the more critical to stay on top of your skills. And if you aren’t getting tubes in the field, the only other place to hone your technique is through training.

The call comes in as a “gunshot wound to the head,” and you arrive on scene to find a middle-aged male with what appears to be a self-inflicted, small caliber entry wound to the right temple. He is sitting in a recliner and bleeding profusely from the nose and mouth. You carefully place him on a backboard, but once he is supine, his airway quickly fills with blood. Things are not looking good.