EMS: Respiratory Difficulties

(originally posted 09/12/05)

This is all stuff we covered in EMT class, but because I'm a nerd/geek/whatever I had to go look for pictures and stuff on the internets. ;)

First off, the intercostal spaces are those spaces between your ribs. Auscultation (listening with a stethoscope) of lung sounds is done over the intercostal spaces.

Intercostal retractions are one of the signs of breathing difficulty. This man has two commonly observed signs of breathing difficulty: intercostal retractions (visible) and he is also sitting in the tripod position.

The tripod position is when a person sits leaning forward, with their hands on their knees or on another surface. This is a commonly observed sign of breathing difficulty.

The man in tripod position in this picture also has pursed lips, another sign of breathing difficulty. Note the presence of a nasal cannula. Perhaps he has emphysema.

The site referenced immediately above also shows an image of the nail beds in the state of cyanosis (another sign of breathing difficulty).

Here is yet another resource online, for the EMS-student community.

Dr. Ed Friedlander on respiratory pathology. Links to many great photos.