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Look through the information provided in this case study and highlight all of the information that might concern you as a paramedic.

  Aside from auscultation, which you have already done, what examination techniques should you incorporate into this patient assessment? Inspection – observe the chest for an abnormalities such as wounds, scars, bruising, asymmetry and recession.Palpation – feel for any asymmetry, vocal fremitus and tenderness.Percussion – hyper‐ or hypo‐resonance.

  What adventitious (added) sounds might indicate asthma and why? Expiratory wheeze. This sound is made when air has a restricted path through the bronchi, due to inflammation and muscle spasm in the airways.

  What medicine (pharmacology) is likely to relieve the patient’s symptoms and why? Nebulised salbutamol – it is a Beta2, adrenergic agonist that relaxes smooth muscle in the bronchi.