Differentiate asthma, COPD, CHF, and pneumonia — treatment differs significantly.
Steps by Cert Level
ALL: High-flow O2. Position of comfort (upright). Assess lung sounds — wheezing vs crackles changes treatment.
EMT: Assist patient with own prescribed inhaler. Supplemental O2. CPAP if authorized and available.
AEMT: Albuterol 2.5mg via nebulizer (may repeat x2). IV access. CPAP 5–10 cmH2O for CHF/COPD.
PARAMEDIC: Albuterol + Ipratropium (DuoNeb). Methylprednisolone 125mg IV for severe asthma. Mag Sulfate 2g IV over 20min for refractory bronchospasm. Heliox if available. Intubation only as last resort in asthma — very high risk.