5 Respiratory Complications

Recognize respiratory deterioration

Respiratory complications can worsen quickly. Promptly reassess and escalate when a patient develops sudden breathlessness, chest pain, abnormal or one-sided breath sounds, increasing work of breathing, altered alertness, or falling oxygen saturation.

Assess airway and breathing, monitor the patient, and seek appropriate clinical help when deterioration is suspected. Follow local protocols, including the local early-warning or emergency-response process.

Respond to sudden emergencies

Sudden severe shortness of breath with sharp chest pain, markedly reduced breath sounds on one side, and a pale or anxious appearance can indicate a possible Pneumothorax. Activate urgent clinical help and support airway, breathing, and oxygenation. Do not delay escalation while waiting for a chest X-ray if the patient is deteriorating.

Acute breathlessness and tachycardia with new chest pain and one swollen, tender calf raise concern for Pulmonary embolism. Arrange urgent assessment and monitor the patient closely. These symptoms alone do not confirm the diagnosis.

Assess infection and fluid-related signs

Fever, a productive cough, increasing breathlessness, and crackles heard over one area of the chest can occur with Pneumonia. Assess vital signs and oxygenation, consider the severity of the symptoms, and arrange prompt clinical assessment. Escalate according to the patient’s condition.

Worsening breathlessness while lying down, crackles in both lungs, and visible distress can occur with Pulmonary edema. Sit the patient upright, assess airway and breathing, monitor oxygenation, and urgently escalate for clinical assessment.

Act promptly after choking

If a patient suddenly coughs and chokes while eating, then develops noisy or difficult breathing, stop the meal and call for help. Assess airway and breathing, and provide appropriate immediate airway support within your training and local protocol. Do not continue oral intake while the airway needs assessment.

Reduce postoperative respiratory risk

Several hours after surgery, shallow breathing and avoiding coughing because of pain can contribute to Atelectasis. If consistent with the patient’s care plan, support pain management and encourage appropriate deep breathing, coughing, and mobilization. Reassess respiratory status.

Reassess and escalate

Reassess promptly when a patient’s respiratory rate rises, they become restless, use accessory muscles, struggle to complete sentences, or have a fall in oxygen saturation. These warning signs are concerning together; do not rely on a single oxygen-saturation value or wait for the next scheduled observation.

Check the oxygen delivery system, monitor vital signs, and escalate through the local early-warning or emergency-response process. Use oxygen according to the prescribed target and local protocol, and seek urgent help when deterioration is suspected.

• Aspiration