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Clinical Competence Skill Set- SCI Respiratory Assessment

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Description #

This unit is designed to review the skills involved in respiratory assessment of a Spinal cord injured patient. This unit will be administered online with a pre and post quiz. Accumulated knowledge from all of the units will be practiced and evaluated via case scenarios using the simulated patient.

Learning Objectives #

At the completion of this module the student will be able to:

  • 1. Describe the techniques for completing a respiratory assessment on a spinal cord injured patient.
  • 2. Be able to perform a respiratory assessment of a patient.
  • 3. Identify precautions and special considerations discovered from this assesment that impact their treatment plan

SCI Respiratory Assesment #

Information from the Chart

Observation

Vitals

Physical assesment

Other teats

Clinical reasoning

Treatment planning

Physical Assessment #

Present Respiratory Status:

Respiratory Rate – breaths per minute

Rib Fractures – location and if a flail segment presents

Respiratory muscle activity:

·         Diaphragm – bilateral or unilateral innervation

·         Intercostals – presence of lateral costal expansion, symmetrical/asymmetrical

·         Accessory muscles – recruitment and degree of activity

·         Breathing pattern – diaphragmatic, upper thoracic, use of accessory muscles, paradoxical pattern, splinting due to pain

Chest mobility – flexible or rigid and any previous deformities eg. due to COPD, ankylosing spondylitits, scoliosis and /or kyphosis

Auscultation – describe type and location of breath sounds, air entry and adventitious sounds eg. crackles, wheezes, pleural rub

Cough Function – innervation of abdominal muscles and ability to generate an expiratory force to clear secretions:

·         Functional: no assistance required, clears all secretions

·         Weak Functional: clears small amounts of secretions from upper airways but requires assistance when a respiratory infection presents

·         Non-Functional – unable to generate an expiratory force

Lab Data, Investigative Findings:

  • Pulmonary investigations: pulmonary function tests, chest x-ray, V/Q scan, arterial blood gases, or oximetry and capnography if available

Current Respiratory Management

  • If ventilated identify type of ventilator, mode of ventilation and parameters
  • Oxygen therapy: mode of delivery and O2 flow or percentage
  • PT treatment eg. deep breathing and assisted cough, postural drainage, manual techniques