ABSTRACT
Respiratory history is usually gained from individual handover and interdisciplinary notes – medical, nursing, physiotherapy. Other signs of respiratory problems include: inability to complete sentences without pausing for breath, sudden confusion – more often caused by hypoxia than nonrespiratory factors, and cyanosis – a late sign, appearing only with desaturation lesser than 85–90%, and not appearing with severe anaemia. This chapter includes auscultation and ventilator observations, including waveform analysis. Abnormal sounds may be heard on inspiration, expiration, or on both phases, so, having identified abnormal sounds, nurses should listen to further breaths to identify on which phases sounds occur. Capnography enables continuous non-invasive breath-by-breath monitoring of expired concentrations and should be used on all intubated ventilated patients. Most ventilators can display three breath waveforms: pressure, flow, and volume. Pulse oximetry is non-invasive and continuous, so is a useful means to monitor oxygenation.
