Troubles of Transport: How to Transport a Patient in Respiratory Distress

When faced with the challenge of transporting someone in respiratory distress, emergency responders should be able to identify the symptoms and remain prepared to spring into action with the right procedures and equipment. 

Detecting Distress

Respiratory distress, also known as acute respiratory distress syndrome, is respiratory failure caused by widespread inflammation in the lungs, shortness of breath, and is a potential cause for ventilation. Examples of respiratory distress include:

1. Primary Respiratory Distress, meaning the problem is directly in the lungs.
2. Secondary Respiratory Distress, meaning the lungs are having to work overtime to compensate for other issues in the body.

Emergency responders will be able to offer patients a better chance at survival when they arrive on the scene if they’re experts at identifying signs of respiratory distress. Eight key indicators to help first responders pinpoint a respiratory issue. include:

• Shortness of Breath (Dyspnea): Experiencing difficulty in catching your breath or breathing normally.
• Rapid Breathing (Tachypnea): Breathing at an accelerated rate, often a sign of insufficient oxygen.
• Wheezing or Whistling Sounds: Producing high-pitched noises while breathing, usually due to constricted airways.
• Chest Pain or Tightness: Feeling discomfort or pressure in the chest, which may intensify with breathing.
• Blue or Pale Skin (Cyanosis): A bluish or pale tint, particularly noticeable around the lips or fingernails, indicating reduced oxygen levels.
• Fatigue: Severe tiredness or weakness, especially during light activity, resulting from inadequate oxygen.
• Confusion or Dizziness: Experiencing lightheadedness or difficulty thinking clearly due to a reduced oxygen supply to the brain.

How to Position the Patient

According to EMS World Expo, patients should always be positioned in a way that relieves pressure from their chest and lungs. The position is formally called Fowler’s Position, but the patient should always be sitting upright. The positioning of a patient can be a life-or-death factor, so be sure to listen to the patient and take the specific circumstances of the emergency into consideration. For example, if someone is hypotensive, they should be placed completely flat on the stretcher so the patient’s heart is not pumping against gravity.

Use the Right Equipment

During transport, patients with respiratory distress will often be put on a transfer ventilator. Transport ventilators are instrumental for ensuring that the patient has a consistent oxygen intake. The three different modes of ventilation include:

1. Pressure-support ventilation augments the patient’s inconsistent inspiratory effort by providing a consistent distribution of oxygen during inspiration to a preset limit.
2. Pressure-control ventilation delivers volume until the desired pressure is reached during inspiration.
3. Volume control and time-limited ventilation deliver the desired air amount within a certain period.

There can be an overwhelming number of factors to keep in mind when transporting a patient in respiratory distress, but with the right preparation and knowledge, emergency responders can handle the pressure smoothly. Being able to identify the symptoms and signs of respiratory distress, knowing how to treat them, and understanding how to operate necessary equipment will aid EMS professionals in smoothly and efficiently saving the lives of patients experiencing airway emergencies.

 Editor's note: This blog was originally from June, 2023. It has been re-published with additional up-to-date content.