COVID-19 is the disease caused by the SARS-CoV-2 virus. Paramedics are at the frontline of healthcare delivery, including during the SARS-CoV-2 pandemic. The virus poses specific problems for paramedics. These involve treating and transporting infected patients, as well as considerations around decontamination and disinfection of ambulances and medical equipment. All respiratory infections should be considered COVID-19 until proven otherwise so paramedics should wear personal protective equipment (PPE). PPE consists of gloves, gowns, aprons, surgical face masks, protective eyewear and face shields. Paramedics should receive training and guidance on PPE so they can select and use it properly. The type and level of PPE used will depend on the level of protection required, and risk should be assessed. Widespread testing will give a clearer picture of the incidence and distribution of the virus.

In this series of articles, the authors outline what they consider to be essential/core critical care skills that all nurses should possess in order to timely and appropriately assess critically ill patients. It is anticipated that the possession of these core skills will enable nurses to appropriately assess and identify those patients who are at risk of deterioration. By comprehensively assessing individual patients and identifying problems early, nurses can initiate specific interventions that may stabilise and/or improve patient outcomes and help prevent unnecessary intensive care unit admission. Having covered respiratory assessment here, in subsequent articles the authors will outline and discuss the following key critical care skills that all nurses should possess: cardiac and circulatory assessment, neurological assessment, hydration status assessment, fluid management and intravenous therapy. In this article the authors discuss the airway, breathing and circulation (ABC) approach to patient assessment and then focus on respiratory assessment and management.

Paramedics are at the frontline of healthcare delivery and this includes during the current coronavirus pandemic. This pandemic poses specific problems for paramedics, which include not only treating and transporting infected patients, but also issues around decontamination and disinfection of ambulances and medical equipment. Of particular concern is the pneumonia associated with the 2019 novel coronavirus. Data on COVID-19 pneumonia are developing. Ongoing research demonstrates that almost all serious consequences of COVID-19 feature pneumonia, especially in older people and those with comorbidities. Paramedics can have a profound effect on the care of patients with pneumonia. Effective management of COVID-19 pneumonia by the paramedic should centre around prompt recognition, early administration of oxygen and intravenous fluids and transfer to hospital. In some situations, paramedics may need to be involved in the delivery and maintenance of airway adjuncts in patients with COVID-19 pneumonia.

Within the hospital environment patients can deteriorate rapidly and for many different reasons. Maintaining a patient's breathing is the main priority in any emergency situation--although achieving airway control can be difficult. All health professionals need to be able to safely undertake airway management and the key to the management of an airway is through a thorough assessment, to firstly ensure whether the airway is patent or not. This article will discuss airway management--both acute and chronic--as well as associated nursing care.

All nurses should possess core critical assessment skills in order to appropriately assess critically ill patients. It is anticipated that the possession of these core skills will enable nurses to appropriately assess and identify those patients who are at risk of deterioration. By comprehensively assessing individual patients and identifying problems early, nurses can initiate specific interventions that may stabilize and improve patient outcomes and help prevent unnecessary intensive care unit admission.